The pharmacy department at Brigham and Women’s uses a variety of robotic technologies to assist in its transition toward bringing sterile compounding in-house. Bill Churchill, MS, RPh, the hospital’s chief of pharmacy services, said the technologies have significantly boosted workplace efficiency and patient safety—and saved scarce health care dollars in the process.
Until the latter part of 2013, three primary robotics systems were in use at Brigham and Women’s, Mr. Churchill noted: Health Robotics’ i.v. Station, which is used to compound batch-prepared drugs, as well as patient-specific IV bags and syringes; an Intellifill syringe robot, from Baxter, that prepares bulk batches of ready-to-use syringes (primarily for anesthesia and nursing staff); and Health Robotics’ CytoCare robot for preparing chemotherapy products.
Bill Churchill, MS, RPh, observes the IntelliFill robot sort syringes.
Since that time, “in our efforts to continually evaluate our technology, BWH has moved toward standardizing our robotic technology,” Mr. Churchill said. As a result, “we’ve moved away from the Intellifill and the CytoCare units, by bringing in two additional i.v. Station robots, and we are awaiting delivery of an i.v. Station Onco robot that will replace the CytoCare [unit].”
He added that BWH also is using Aesynt’s i.v. Soft Assist system to streamline workflow related to manual compounding. “This basically helps us to supplement robotic production with manual processes as efficiently as possible,” Mr. Churchill explained.
The gain in volume and efficiency that occurred as a result of these technologies has been significant, Mr. Churchill noted. The systems can aid in the preparation of more than 400,000 doses annually, all of which were previously done off-site and shipped to the hospital at significantly higher costs, he noted. Moreover, the robots have contributed to approximately $1.5 million in savings, Mr. Churchill said. The cost savings, he noted, were largely a result of shifting from higher-cost outsourced products to less expensively prepared products made at the hospital. “The calculation was a straightforward business analysis that was performed to get approval for the robotic devices, and then revalidated to prove ROI [return on investment] savings,” he said.
Mr. Churchill stressed, however, that the importance of cost savings pales in comparison to the safety gains that occur as a result of increased automation. “IV medications that are prepared by humans are approximate—USP standards allow a range of plus or minus 10% of what the label amount says, but there can be much greater range of variability in the accuracy of preparation.” He added that the robots measure these medications not only by volume, but also by specific gravity, with an accuracy of plus or minus 5%.
“That higher level of accuracy makes a difference for many patient populations, including elderly [patients], patients with renal or liver disease, as well as neonates and pediatric patients, to name a few.”
—Steve Frandzel, David Bronstein