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26 Technology
Pharmacy Practice News • July 2022
Automation IV-WMS and robotics:
9 Steps for Implementing Tech Solutions in the IV Room By Gina Shaw
Phoenix—At least nine different IV workflow management systems (IVWMS) and seven different IV robotics systems are available for hospital pharmacies’ IV compounding needs as of this summer. Choosing the right one depends on several key factors that technology leaders should heed when evaluating a purchase, two compounding experts noted at the 2022 ASHP Summer Meetings and Exhibition. The technology ranges from basic, affordable but still very functional systems to multimillion-dollar, fully automated robotic IV compounding systems, noted Michael Freudiger, PharmD, the compounding and regulatory compliance supervisor at Valley Children’s Healthcare, in Madera, Calif. “What you select will depend on your institution’s needs, but it is common sense that any hospital that does IV compounding should have at least one of these solutions,” Dr. Freudiger told Pharmacy Practice News. “IV workflow management systems may not be mandated as of yet, but they should be the industry standard.” Dr. Freudiger and Patricia Kienle, RPh, MPA, BCSCP, the director of Accreditation and Medication Safety for Cardinal Health, offered nine recommendations for choosing the right IV-WMS and/or robotics system:
Do a gap analysis. “Bring together a team to assess where errors are most likely to occur in your IV compounding setup based on your work practices,” Ms. Kienle said. “That team should ideally include not only leadership from the pharmacy, but also the risk manager for your facility, who likely knows about safety gaps that have occurred that may be confidential to the rest of the organization. They see the bigger picture.” Ms. Kienle also advised involving nursing expertise, including an infection control nurse and, if you have a significant oncology practice, an oncology nurse. “These nurses can see gaps from an end-user perspective that may be missed in the pharmacy.” Know your options (see Table 1) and use a scorecard to rate them. “After you’ve assessed your system’s needs, review the available technologies and see where those systems would line up with your requirements,” Dr. Freudiger said. For IV-WMS, he suggested starting with several fundamental desired features, including barcode scanning and automation (a must); gravimetric verification, which the Institute for Safe Medication Practices (ISMP) states is optimal; electronic documentation for remote verification; dose tracking; and integration with other systems. “That last item can be particularly variable and institution-specific,” he said.
Table 1. What’s Currently in Use IV workflow management systems • BD Pyxis IV Prep (Becton Dickinson)—formerly BD Cato • IVX Workflow (Omnicell) • i.v.SOFT Assist (Omnicell)—discontinueda • DoseEdge (Baxter) • Dispense Prep (Epic) • PharmacyKeeper (Grifols) • Assure-Trak (ConsortiEX) • DrugCam (Eurekam) • Diana Compounding Workflow System (ICU Medical) IV robotic systems • APOTECAchemo (Loccioni) • RIVA (ARxIUM; Intelligent Hospital Systems) • INTELLIFILL I.V. (Baxa Healthcare)—discontinued
A don’t-miss resource for health systems interested in specialty pharmaceuticals and services.
• Equashield Pro (Equashield LLC) (CSTD robot) • KIRO Oncology (Grifols USA) • i.v.STATION (Omnicell) • i.v.STATION ONCO (Omnicell)
Brought to you by the same team who publish
• IVX Station (Omnicell)—new in 2022 a
Discontinued systems are included if they are still deployed in health systems.
CSTD, closed system drug-transfer device Source: Michael Freudiger, PharmD.
