DISCLAIMER OBJECTIVES IV ROBOTICS IV ROBOTICS

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1 DISCLAIMER NEW PHARMACY TECHNOLOGY AND AUTOMATION UPDATE Christopher R. Fortier, PharmD Manager, Pharmacy Support Services Clinical Assistant Professor Medical University of South Carolina Charleston, SC Speaker does not have any conflicts of interest and does not favor any vendors over another for any technology discussed in this presentation. Organizations must consider Board of Pharmacy license and permit requirements for the various technologies and automation presented. OBJECTIVES NEW TECHNOLOGIES/AUTOMATION Identify new pharmacy technology and medication use automation products entering the healthcare informatics market Evaluate the advantages and limitations of these new pharmacy technologies Apply pharmacy informatics imperatives in developing a new pharmacy practice model IV robotics Telemedicine Telepharmacy Clinical surveillance system Smart pumps integrated with BCMA e-prescribing Anesthesia carts Additional technologies Health Robotics/Devon Robotics CytoCare i.v. STATION Baxa - formerly ForHealth Technologies IntelliFill i.v. Intelligent Hospital Systems RIVA Health Robotics/Devon Robotics CytoCare Requires Baxa two-fer vented needles/waste containers Makes syringes, IV bags, elastometric infusers, and bottles Technician checking robot every 15 min 25 chemo doses/hour Nancy Stolpman, University of Colorado 1

2 Baxa - formerly ForHealth Technologies IntelliFill i.v FTE to operate 12mL syringes for doses from 0.5mL to 11.5mL Modes Batch, first, snap, reservoir Produces up to 700 syringes/hr Reconstitutes, multi-dose draw, serial dilution Intelligent Hospital Systems RIVA Interface with PIS Syringes (1-60mL) and IV bags (25mL -100mL) Patient specific, batch, mass, repetitive Records syringe, bag, drug vial for review Also compounds hazardous drugs TELEMEDICINE Health Robotics/Devon Robotics i.v. STATION Compounds Syringe 1mL to 60mL Bag 50mL to 1 L Vial 1mL to 100mL Patient specific or batch IV doses 60 syringes/hr and 24 bags/hr Savings over pre-mixed bags Currently in beta testing Rural hospital Large medical center Community hospital TELEMEDICINE PHARMACY AND TELEMEDICINE Pharmacist After hours order entry Clinical service Collaborate with telemedicine team and on-site teams Screen drug therapies Resolve drug related problems Appropriate antibiotic coverage, formulary support Renal/hepatic dysfunction, high cost drugs CMS measures Pharmacy technicians Triage calls, problem solving, and tech order-entry 2

3 ScriptPro ScriptPro Telepharmacy ForHealth Technologies IntelliFlow Rx In IV room, technician acquires medication and work label Technician i selects patient from pending work list Mike Brownlee, Oregon Health and Sciences Medical Center Technician scans bar code on medication(s) to confirm it matches order Technician takes picture(s) of medication vial, syringe, work label, and fluid before injection Mike Brownlee, Oregon Health and Sciences Medical Center Pharmacists reviews pictures taken by technician and compares to work label 3

4 CLINICAL SURVEILLANCE SYSTEMS Vendors Vigilanz SafetySurveillor Sentri7 Theradoc Others CLINICAL SURVEILLANCE SYSTEM Medication safety program ADR detection, prevention, and documentation Pharmacist clinical interventions Document, track, and reporting Regulatory Anticoagulation, contrast media, recalls/shortages Quality CMS core measures Drug utilization Antibiotic stewardship Gettyimages.com CORE MEASURE DASHBOARD ANTICOAGULATION ALERTS ADE ALERTS H1N1 MANAGMENT 4

5 SMART PUMPS AND BCMA SMART PUMPS WITH BCMA Scan patient Scan drug Scan device channel Confirm infusion emar electronic charting CPOE e-prescribing Provides authorized prescribers with secure access to real-time patient level prescription benefits and prescription history to make informed prescribing decisions that are clinically appropriate and economical for patients Pharmacy eligibility, benefit coverage, and formulary e-prescribing Benefits Role in medication reconciliation More complete med history Display economic alternatives No illegible handwriting Reduces pharmacy callbacks Prescription refill processing Prescription history Patient compliance Therapeutic interventions Drug interactions ADE Duplicate therapy e-prescribing ANESTHESIA CARTS DEA final rule to permit e-prescribing of control substances is still being drafted Incentives created under the Medicare Improvements for Patient and Providers Act of 2008 (MIPPA) Medicare bonus payment 2% incentive to physicians for 2 years beginning in % in 2011 and % in 2013 Decrease Medicare reimbursement for non-adopters -1% in % in % in

6 ANESTHESIA CART MEDICATION RECONCILIATION Vendors Omnicell Anesthesia Workstation McKesson Anesthesia-Rx Others Benefits Bar code scanning Documentation Medication labeling Narcotic control Charge capture Inventory management Restock scanning Allergy alerts MEDICATION CAROUSELS RFID PATIENT REMINDER SYSTEMS PATIENT REMINDER SYSTEMS

7 PATIENT HEALTH RECORD ADM SCANNING REMOTE DISPENSING PORTABLE DEVICES FUTURE CONSIDERATIONS Government grants for EHR Pharmacy informatics role/seat at table Technology integrated into pharmacy practice model to enhance and expand clinical pharmacy services Hospitals need dto work with vendors to improve systems Research and contribution to the literature are essential 7