Jerry Fahrni

Tag: Pharmacy Automation

  • 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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  • 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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  • 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.

  • PillPack: a new way of thinking about an old problem

    I read a Wall Street Journal article this morning about an online pharmacy called PillPack that’s doing something a little different. “PillPack mails its customers their medications every two weeks, but rather than putting them into several big bottles, the company pre-sorts them into sealed, single-dose packs, based on when a patient needs to take their medications throughout the day. The pills arrive in a long chain of dose packs, linked together on a recyclable dispenser roll.”

    It’s not a new concept at all. In fact, the idea has been tossed around in certain pharmacy circles for years. Many companies are capable of providing such a service, but most lack the vision to bring the concept to life. Perhaps PillPack can provide enough value to its customers to make it viable. I really hope it works out for the company. At least they’re thinking outside the box, er, inside the box.

    PillPack should really think about partnering with local hospitals and deliver discharge meds to the patient bedside in this handy format. Counsel the patient, make sure they have their meds, automatically enroll them in the mail order service, and so on. Just sayin’.

  • What are you looking for in a “workflow management system” for the IV room?

    A recent “I’ve been thinking…” by Mark Neuenschwander got me thinking; no pun intended. Mark and I have been working on a barcode medication preparation (BCMP) project for the last couple of months. My interest in pharmacy automation and technology coupled with his passion for barcoding in healthcare and patient safety have created a good working relationship. We’re currently looking at the state of BCMP as it relates to compounding in the IV room.
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  • High-speed unit dose packagers for pharmacy

    There are a lot of pharmacies out there that utilize high-speed packagers for one reason or another. Sometimes medications aren’t available in unit-dose packages from the manufacturer, or in one case that I came across recently, a pharmacy may elect to package from bulk bottles for efficiency and/or cost savings.

    I haven’t given much thought to high-speed packagers in a while because they seem to be a low priority in many pharmacies these days. But I had reason recently to give them some thought. Someone sent me an email asking me about the various high-speed packagers on the market, who sells them, who they’re made by, etc. So I put together the table below. It covers the basics.
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  • Swisslogs introduces next-gen RoboCurrier Autonomous Mobile Robot

    Swisslog has been making these little robots for a long time, although I don’t see many of them in the wild these days.

    They’re pretty cool in their own right. The robots themselves are reasonably small. The previous version was only 35-inches tall, and weighed in around 100 pounds. But they could carry up to 50 pounds worth of cargo and could navigate around the hospital completely on autopilot. I’m not entirely sure, but I believe they use RFID technology to navigate.

    [Update 08 01 2013]: According to Swisslog the RoboCurrier “utilizes an obstacle avoidance system and mapping software that’s set up during installation“.

    One of the coolest features though is use of a prerecorded message to announce its arrival.
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  • Saturday morning coffee [March 30 2013]

    MUG_MPSo much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

    The coffee mug to the right comes straight from Moonstone Pottery in Los Osos, California. It’s a pretty cool mug. It was a gift from my brother, Robert. Thanks bro.

    The Croods was #1 at the box office last weekend to the tune of nearly $44 Million. I didn’t see that one coming. I knew that the movie was out, but had no interest in seeing it. My family chose instead to see Olympus Has Fallen. It was terribly predictable and a bit corny, but I liked it. It was full of lots of gratuitous violence and gun play, which makes it my kind of movie. Just for the record, Jack the Giant Slayer has officially flopped at the box office.
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  • Center for the study of pharmacy automation and technology [idea]

    MadScientistEarlier this week I put up a post about a Prezi created by Dr. Robert Hoyt called Evidence Based Health Informatics: Replacing Hype with Science. It was a great presentation about a lot of the technology that healthcare has adopted over the years without any real evidence to back it up. I wish you could all see it, but it appears that someone has pulled it down. The link I have for the Prezi is dead. Bummer

    Anyway, the Prezi got me thinking about how we have many technologies in pharmacy that have precious little, or no data to support their use. We use carousels, high-speed packagers, tabletop packagers, robotic medication distribution, robotic IV preparation along with other IV room technologies, smart IV pumps, automated storage cabinets, and so on. The data we do have for these items is typically provided by the manufacturer’s themselves, which makes it biased in the best of situations and completely worthless in the worst cases.

    Pharmacy is in desperate need of an academic center for the study of pharmacy automation and technology. The center would study the use of pharmacy technology in different use cases, collect data, and provide the pharmacy community with the information. Look at robotics versus carousels for distribution. Analyze cross contamination in high-speed packagers versus tabletop models. Perform time-motion studies on cart fill vs. automated dispensing cabinets for medication distribution, and compare the safety of one over the other. Analyze pharmacy inventory costs of one technology over the other. And so on, ad infinitum.  Conclusions wouldn’t be necessary as simply presenting the information in an easy to understand format would suffice. Let the end users draw their own conclusions. Every practice setting is slightly different, and what may work for one may not work for another. But understanding how a piece of technology or automation fits into a particular practice model might be a significant benefit to many.

    The center would tear the automation and technology apart, both figuratively and literally to unveil all there is to know about each and every piece.

    Such a place would have to exist at a well respected academic research center as it is the only way to ensure some semblance of impartiality.

    How would it be funded? Ah, there’s the rub. Getting funding for such an endeavor would be difficult at best. A lot of this equipment is expensive. Of course the best place to troll for money would be the pharmacy technology vendors themselves. After all, they have all the equipment that would be needed to perform the research. Unfortunately this is unlikely to happen as most companies will not be willing to drop resources into a project that they have no control over. What if the outcome of such research reflected poorly on their products? That would not only be embarrassing, but could potentially hit them in the pocketbook. No, they couldn’t risk it. How about the federal government? Perhaps, but that might be like getting blood out of a turnip these days.

    Getting the equipment and funds would definitely be the hardest part. There’d be no shortage of pharmacists interested in doing that type of work. What pharmacist could resist playing with giant toys all day long?

    Time to get out my crayons and start drafting a proposal….

  • #1 thing to consider when buying pharmacy automation and/or technology…

    There are a ton of things to consider when you’re thinking about putting new technology in the pharmacy. You have to consider the cost, the impact on your operations, the reputation of the company that you’re buying from, what type of technology you’re going to buy, and so on and so forth ad infinitum.

    However, the number one thing you must consider before taking the plunge is whether or not the technology fits your dispensing model. Do you still do a cart fill? Are you completely decentralized? Are you using a just-in-time dispensing model? Will the technology that I’m looking at fit what I hope to accomplish? You need to think about that long and hard before making a decision.

    It’s like buying a new vehicle. You certainly don’t buy a Toyota Prius if you need to pull a 24 foot Centurion Enzo SV244 – a really nice boat – to the lake on weekends. No, instead you buy a new Ford Super Duty truck. I know that makes perfect sense to you, yet I hear people frequently say “it doesn’t fit the way we work” when talking about pharmacy automation and technology. When they say that, the first thing that pops into my mind is “then why did you buy it?”. It’s a question that needs serious consideration because some of this stuff is expensive.

    I experienced this firsthand in my previous role as an IT pharmacist. We installed new technology that didn’t really fit our distribution model all that well. We tried to cram the technology into an manual process. Didn’t work. I fought it for a few months until the light bulb finally went off. Once we got out act together we redesigned the process around the technology. We took advantage of the automation and filled in the gaps where necessary. It fundamentally changed the way we did things, and in the process improved the overall distribution process.

    So before you go and buy a robot, or a carousel, or a high-speed packager, or a compounding machine, make sure you ask yourself how you’re going to use it.  This stuff isn’t top secret. Do a quick Google search. Watch some videos. Talk with hospitals that do the same things as you.

    In a nutshell do your homework before taking the plunge because once you take the plunge and decide you’ve made a mistake you can only do one of two things: 1) change automation, or 2) change the way you work.