20Ways WINTER Hospital 2021 by RXinsider

WINTER 2021

I M P R O V I N G PAT I E N T CARE & PHARMACY COST CONTAINMENT H E A L T H

20 Unique Products & Services

S Y S T E M

I N F U S I O N

E D I T I O N

Decision-Making for Drug Diversion A Case Study From Medacist page 70

Discover 20 products and services that will help your pharmacy improve patient care or contain costs.

Drug Diversion Industry Expert Q&A, Market Leaders Buyer’s Guide, and More page 60

7 Case Studies Waste Management, Veltek Associates, Inc., Culturelle, IMI, Azina, Modular Devices Inc., and More

Robert Fink, Pharm.D., MBA, FACHE, FASHP, BCNSP, BCPS Chief Pharmacy Executive ~U ofL Health, Louisville, KY

ARE YOU

COMPLIANT?

WE’VE GOT YOU COVERED

Your One-Stop Compliance Shop. Everything You Need to be USP <797> & <800> Compliant.

DISINFECTANTS & CLEANERS

GLOVES & PPE

PHARMACY SUPPLIES

CHEMO RATED PRODUCTS

SPEAK DIRECTLY WITH A PRODUCT EXPERT 888.909.7700 | pharma-choice.com info@acutecareonline.com Poway, CA

COMPANY

P ROV I DI NG T H E H IG H E ST QUA L I T Y OF P H YS IC A L PHARMACEUTICAL INVENTORIES SINCE 1979 Utilizing Decades of Knowledge & Experience Why Choose Capital for Your Pharmaceutical Inventory Needs? • Teams of experts conduct the inventory within a few hours. • Eliminate the need for overtime or coordination of staffing to accommodate inventory process. • Teams conduct pharmacy inventories daily, not annually. • Teams work seamlessly around the pharmacy staff ensuring that the “snapshot” is a true representation of the inventory on-hand. • Minimal interruption to the pharmacy staff and operations. • Competent inventory specialists that can work with finance and/or external audit firms to validate the inventory. • Collaboration with the pharmacy to provide an accurate report in a timely manner. • Expert valuation and pricing of the inventory by an independent party. To schedule your next inventory, please call 1-800-345-0849 or email customerservice@capitalinventory.com.

SMART THINKING.

AVAILABLE PRODUCTS Description SmartPak® provides a revolutionary delivery system for these essential drugs, offering faster, easier preparation more economically. It’s also safer. The SmartPak bag system is a convenient alternative to using multiple glass vials. No glass means no breakage during handling. SmartPak saves time and labor with less waste. SmartPak — the smart choice for your pharmacy service.

Cefazolin 100 grams Cefazolin 300 grams

Ceftriaxone 100 grams

Vancomycin 100 grams Cefepime 100 grams

NDC

List#

66288-1100-1

1100

66288-1300-1

1300

66288-6100-1

6100

66288-7100-1

7100

66288-8100-1

8100

www.samsonmt.com Toll Free (877) 418-3600 PO BOX 2730, Cherry Hill, NJ 08034 Telephone (856) 751-5051 Fax (856) 751-5044

Contents Innovative. Dedicated. Proven. Your true partner for 340B program administration and compliance. Verity Solutions® is a recognized leader in 340B program optimization. We drive continually improved solutions and vigilantly address regulatory changes so that our customers can dedicate fewer resources to program administration and more resources to community wellness.

Results you can believe in.

Partner with us to simplify 340B program management, confidently optimize federal pricing benefits, and benefit from the knowledge and support of our expert team.

1.800.581.1378 info@verity340b.com www.verity340b.com

VERIT Y 340B® SP L IT B IL L ING | C ONTRACT P HARMACY SP ECIALT Y C ONTRACT P HARMACY | C OM P L IANCE MANAG EM ENT | P U RCHASE ANALY TICS | VHU B®

Verity Solutions — Invested in Your 340B Program Success

Partner with us to simplify 340B administration, confidently optimize federal pricing benefits, and benefit from the dedication and knowledge of our expert team.

Point-of-Sale to Support Your Outpatient Pharmacy Operations — Retail Management Solutions

FUNCTIONALITY YOU NEED. SERVICE YOU TRUST. POINT-OF-SALE MADE CRAZY EASY.

Customized Software

Innovative Training

WHY CHOOSE RMS? RMS is dedicated to helping pharmacies improve patient outcomes through innovative point-of-sale solutions. RMS’ solutions are flexible, scalable, and customizable to meet the needs of any pharmacy.

Improve patient outcomes, streamline pharmacy management, and meet pharmacy goals with a point-of-sale solution tailored for your organization and integrated to your choice of over 30 pharmacy management systems.

24/7 U.S. Based Customer Support

Turn-Key Hardware

WITH RMS, YOU CAN... Make informed business decisions using robust reporting Centralize and streamline pharmacy operations Integrate with your choice of pharmacy management systems

Email us at sales@rm-solutions.com, or give us a call at 877-767-1060.

Implement programs like meds-to-beds and will-call

page 33

Meeting 797> Requirements Requirements Meeting Your Your USP USP<<797> Veltek Simple Veltek Makes Makes Itit Simple

C CLEANING LEANINGAND AND DISINFECTING ISINFECTINGPP RODUCTS D RODUCTS

EENVIRONMENTAL NVIRONMENTAL MONITORING ONITORING M QUIPMENT EEQUIPMENT

GOWNING OWNING G

USP 800 Gown

Cleanroom Garments

VAI every aspect necessary for full compliance including: VAIcovers covers every aspect necessary for full compliance

including:

Consultation on maintaining aseptic processes onsetting settingupupand and maintaining aseptic processes • ■Consultation our easy easy to useto disinfectants in pre-measured containers RTU containers SimpleMix –– Veltek’s use disinfectants in pre-measured • ■SimpleMix® Easy2Gownsterile sterile garment garment system system • ■■Easy2Gown Easytotouse use SMA portable SMA air samplers MicroPortable® ICS - Veltek’s Viable Cleanroom Air Monitoring device • ■Easy RTU Sterile & Non-Sterile cleaners & disinfectants available in a large assortment cleaners & disinfectants available in a large assortment of packaging sizes • Sterile of packaging sizes ®

SCAN HERE

TO CONTACT US

Veltek Associates, Inc. 15 Lee Boulevard Malvern, PA 19355-1234

With VAI’s innovative product line, Meeting USP<797> requirements is just a phone call away…IT’S THAT SIMPLE!

1-888-4-STERILE H E A LT H C A R E

www.sterile.com @STERILE.COM

SMA MicroPortable® ICS From VAI® Offers Superior Precision and Control

Combining experience, innovation, performance, GMP manufacturing, GLP testing services, and unrelenting service has propelled VAI as the ultimate innovative leader in the market.

page 41

Integrated Temperature Monitoring to Support Safe Storage of Vaccines and Medications With Helmer Scientific

Integrated Temperature Monitoring with i.C3® Information System

Continuous monitoring supports safe storage of vaccines and medications

Intelligent diagnostic information and data in one secure location Monitor and optimize performance with a finger stroke Constant monitoring ensures uniform temperature

Continuous monitoring offers safety and security of stored product.

Available on i.Series medicalgrade refrigerators, -30 freezers, and ultra-low freezers

Learn More helmerinc.com/ic3videos

20Ways_TabAd-GX-iC3-winter-2021.indd 1

10/4/2021 4:28:39 PM

page 35

C AS E S T U DY PIKEVILLE MEDICAL CENTER AND AZINA PARTNER TO CREATE INNOVATIVE PHARMACY CAPABILITIES

INTRODUCTION AND INTENDED OUTCOME Pikeville Medical Center (PMC), a 348-bed facility located in southeastern Kentucky, has been dedicated to providing quality care in Kentucky for 97 years. Kandi Justice COO ~ Pikeville Medical Center

page 43

Case Study: Azina

Pikeville Medical Center and Azina partner to create innovative pharmacy capabilities.

Thought Leader Video Series

It’s this objective that prompted PMC to partner with Azina (formerly SPARx, the specialty pharmacy division of Comprehensive Pharmacy Services) to improve drug access for patients, innovate all services, enhance patient care, and increase revenue. “We wanted to leverage our existing retail pharmacy to build an innovative specialty pharmacy,” explains Kandi Justice, COO, Pikeville Medical Center. “Our goal was to provide specialty medications to patients quickly and efficiently. This would enable us to greatly improve the patient experience, as well as keep revenue in-house, instead of relying on numerous third-party pharmacies.”

John Petts, PharmD Vice President ~ Azina

She adds, “Our existing retail pharmacy was a small, 500-square-foot space that used an outdated pharmacy management system to process all prescriptions manually. The pharmacy didn’t have inside access for patients — only a very crowded drive-thru kiosk. We knew we needed to completely overhaul our pharmacy capabilities, and we turned to Azina for help. There was no question that their decades of experience working with hospitals and health systems would be invaluable to us. It became a very strong and collaborative partnership.”

azina.com

page 36-39

page 44-45

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N

ENGINEERING CONTROL REQUIREMENTS for USP-797 and USP-800 Compliance USP 797: Applies to Non-hazardous and Hazardous Drugs USP 800: Additional Requirements for Hazardous Drugs

DRUG TYPE

Sterile Non-Hazardous

Non-Sterile Hazardous

Sterile Hazardous

Horizontal Laminar Flow Cabinet

Powder Weighing Station with Ducting

Class II A2 Biosafety Cabinet w/Ducting

PRIMARY Engineering Control (PEC)

Esco Models: LHG (Horizontal): General compounding LVG (Vertical): Put large machine inside

SECONDARY Engineering Control (SEC)

ISO 8 ante 20 ACPH 0.01 “WG positive pressure

For BUD > 12 hrs

ISO 7 buffer 30 ACPH 0.02 “WG positive pressure

Laminar Flow Cabinet

Esco Models: PW1 (Compact): Single exhaust HEPA ADC (Full-sized): Double exhaust HEPA

Esco Models: AC2 (Compact): Low ceiling, Mobile labs LA2 (Full-sized): Best comfort & safety

ISO 7 buffer 30 ACPH 0.01-0.03 “WG neg. pressure ducted

ISO 7 buffer 12 ACPH 0.01-0.03 “WG neg. pressure ducted Compounding Ventilated Enclosure

ISO 7 ante 30 ACPH 0.02 “WG positive pressure

Biosafety Cabinet, Ducted

ALSO AVAILABLE FROM ESCO Cleanroom Pass Boxes

Esco Models: EPB-SS: Passbox, Full Stainless Steel BIOPASS: Passbox, with H2O2 Decon

Downflow Booth

Esco Model: DFB: Downflow Booth

503B cGMP Isolators

Esco Models: GPPI: General Processing Isolator ACTI: Aseptic Containment Isolator

215-441-9661 Horsham, PA, USA • ETI.Admin@escolifesciences.com • www.escolifesciences.com

340B Program Results Delivered. Period.

Split-Billing

Contract Pharmacy

Superior Technology Intuitive Accumulation Optimize Purchase Orders

Dynamic Dashboard Real-Time Data Exceptional Reporting

Referral Program Increase Claim Capture Close the Loop Remain Compliant

Adding Value 340Basics will change the way your 340B program operates with superior customer service and complete program administration. Partnering with 340Basics will allow your organization more time to focus on patients while increasing 340B savings. This will enable you to invest in new technology, expand staff, improve and/or upgrade equipment, and grow services, all while increasing access to care in your community. www.340Basics.com || info@340Basics.com || 888-356-6225

CONDUCTING IN-HOUSE ACTIVE MICROBIAL AIR SAMPLING MAY BE EASIER AND MORE ECONOMICAL THAN YOU REALIZE! REALIZE! THE TRIO.BAS™ MONO IS A TIME-TESTED SOLUTION TO A ROBUST ENVIRONMENTAL MONITORING PLAN. WHY SHOULD YOU SAMPLE MORE FREQUENTLY? Active microbial air sampling provides a consistent method to trend microbial bioburden over time. Sudden changes signaling increased bioburden will allow quick mitigation of lapses in systems or processes.

Want to see it in action? Hands-on or virtual demonstrations are available

800.266.2222 Sales@HardyDiagnostics.com HardyDiagnostics.com/TRIOBAS

What’s Inside Can Save Lives. Keep it Safe. Choose cold chain products proven worldwide for continued performance and stability even in high ambient temperatures of +32°C (Precision models) and +43°C (Premium models). Learn more at www.bmedicalsystems.com

Blood Bank Refrigerators • Plasma Freezers • Contact Shock Freezers Laboratory / Pharmacy Refrigerators and Freezers Ultra-Low Temperature Freezers • Transport Boxes

B Medical Systems North America LLC 14560 Bergen Boulevard, Suite 200, Noblesville, IN 46060 bmedicalusa@bmedicalsystems.com | Toll Free: (888) 456-7099

Select models ENERGY STAR® Certified

Contents Leiters. We Are Compounding Health™

Helping you deliver better medicine to more people. With increasing regulatory pressure and drug shortages, access to quality medicine is more important than ever. Leiters is an FDA-registered 503B outsourcing provider of high-quality, compounded sterile preparations including: Pre-filled syringes, IV bags and vials ON-Q* Pain Relief System fill services Opioid-free surgical pain services medications Ophthalmology medications and services including FDA-compliant repackaged Avastin®

COMPOUNDING HEALTH™ www.leiters.com | 800.292.6772

ON-Q* is a registered trademark of Avanos Medical, Inc., or its affiliates. Avastin® is a registered trademark of Genentech, Inc.

RXInsider 20 Ways Summer_April2020_FA1.indd 1

Case Study: Veltek Associates, Inc.

C ASE ST U DY ENVIRONMENTAL MONITORING IN COMPOUNDING PHARMACIES: FACTORS TO CONSIDER

Leiters is a trusted FDAregistered 503B outsourcing provider of compounded sterile preparations committed to providing healthcare professionals and their patients with the highestquality medications.

Environmental monitoring in compounding pharmacies: factors to consider.

INTRODUCTION

Cleanroom environmental monitoring in hospital pharmacies and 503A compounding facilities has been a topic of debate over the years. The requirements for viable and total particles air monitoring outlined in USP<797> differ from the recommendations in USP<1116> and sound aseptic techniques generally anticipated by the FDA in a classified drug manufacturing area.5 The differences between these guidance’s cause a wide range of opinions about the frequency and need for viable and total particle air monitoring in hospital pharmacies and other 503A facilities. Of course, like most things the answer is never one sided and the best course for action is most likely somewhere in the middle for these facilities. In this article, we will discuss the importance of environmental monitoring for safe aseptically produced drug products, the differences in regulatory guidance, sources of contamination, strategies for implementing a program, and the equipment your facility may consider if taking more control of your monitoring program — all while saving money in the process.

Jeff Meek Manager of North America Sales, Healthcare Division/ Central Region Manage ~ Veltek Associates, Inc.

WHAT IS ENVIRONMENTAL MONITORING AND WHY IS IT IMPORTANT?

For the scope of this article, we are focusing on viable and total particle air sampling, but that is not to discount the importance (and requirement) of surface, compressed gases, and personnel sampling. Environmental monitoring is a process that is used to monitor the microbial and particulate levels in a classified area. Environmental monitoring of classified areas is a critical step in determining the effectiveness of a facilities engineering controls and to prove the effectiveness of a facilities gowning, cleaning, and disinfecting procedures. The results from your environmental monitoring program are your pharmacies “report card” on just how well your overall program is implemented. Routine environmental monitoring gives the data needed to trend the environmental quality of your classified areas and act when needed.1 EM results also provide sound scientific data to support your rotation scheme between a disinfectant and sporicidal agent. Currently, we rely on an arbitrary time frame for rotation provided by the working compendium. Is the required monthly rotation scheme sufficient specific to your facility? Based on your data trending analysis it may or may not be. Although quite an overkill, some pharmacies apply a sporicide daily for all applications. Generally sporicidal agents are more aggressive on equipment. Their elevated concentration over disinfectants is also unhealthy for worker exposure. Your EM results can support whether in fact this is necessary by determining the species generally detected. Routinely identifying the flora specific to your facility helps us to understand the potential source of the contamination whether it by people related bugs, water bourn bugs, or from outside soil to pinpoint a few. Conducting volumetric testing semi-annually will not provide the sound scientific trending data to support any decision.

SOURCES OF CONTAMINATION

There are many sources of microbial and particulate contamination in the cleanroom. These are broken down into primary and secondary sources of contamination. Primary sources of contamination such as personnel, supplies introduced into the cleanroom, and water bring contamination into the classified area. Secondary sources of contamination are where these contaminates end up settling. Examples of secondary sources of contamination are surfaces, the air, and potentially any equipment used in compounding sterile preparations within your own pharmacy. Primary sources of contamination are controlled by a combination of functioning engineering controls and meticulous personnel training in gowning, cleaning, disinfecting, and hand hygiene. Formulating a sound cleaning and disinfecting program will control secondary sources of contamination but keep in mind that cleaning and disinfecting addresses contamination after the day’s activity. Simply put, if we do not let the contamination in, we would not need to address it. Naturally, all those performing routine cleaning and disinfecting should be competent to execute the facilities plan and the products selected to

sterile.com

4/21/20 11:44 AM

page 47

page 50-53

Capital Inventory, Inc. — Accurate and Dependable Pharmacy Inventory Services

Steri-Tamp® Tamper-Evident Sterile Seals by Allied Pharmacy Products, Inc.

THE MOST INNOVATIVE TAMPER-EVIDENT SEALS IN HOSPITAL PHARMACY TODAY

Our decades of experience working specifically with pharmacy inventory make us uniquely qualified to provide accurate valuations through a streamlined process. Our clients can trust that we will be transparent, supportive, and reliable in every interaction.

• Sterile & Paper Free (USP 797 Compliant).

NEW ISMP & USP 800 IV Bag Seals

IV Bag Port Seals

• Maintains a 100% sterile barrier* with 3X greater adhesion.

The only single-use, tamper-evident seal that both provides and maintains a 100% sterile barrier.

• Helps prevent contamination of drugs and provides added protection to pharmacists. • Will not fall off, even in cold storage conditions (down to -20 degrees centigrade). Vial Seals

• Patented dual-layer indicates true tamperevidence, with “OPENED” marking. • Cost-effective, allows pharmacy to recycle medication and protects patients from dosing errors. • Dispensing and application training videos available on our website to help with JCAHO training.

Tamper-Clear Syringe Seal®

• Available in major wholesalers and distributors.

Red Syringe Seal

*Tested in Nelson Labs, Salt Lake City, UT

Visit our website to learn more: www.steri-tamp.com

page 49

20Ways MISSION To educate pharmacy management on products and services that serve to improve patient care or improve a pharmacy’s financial bottom line, while distilling and presenting this relevant information via 20 product profiles.

page 55

QUARTERLY ISSUES Winter 2021/2022

Fall 2021 FA L L 2 0 2 1

I T Y , C O M M U N

T Y , S P E C I A L

L T C

E D I T I O N

H E A L T H

S Y S T E M

20 Unique 20 UniqueDecis & Drugion-Making Products &Productsfor Diversion Services Services &

I N F U S I O N

E D I T I O N

A Case Study From

Discover 20 products and services that will help your pharmacy improve patient care or contain costs.

Drug Diversion

Industry Expert Q&A, Market Leaders Buyer’s Guide, and More page 60

7 Case Studies

and Discover 20 products your services that will help patient care pharmacy improve or increase profitability.

Medacist page 70

C O M M U N I T Y ,

Celebrating 10 Years RXinsider Reflects on the Past Decade With Retail Management Solutions

S P E C I A L T Y ,

L T C

20 Unique Products & Services Discover 20 products and services that will help your pharmacy improve patient care or increase profitability.

Long-Term Care Delivery/Back-Up Pharmacy Services

Market Industry Expert Q&A, and More Leaders Buyer’s Guide, page 56

Industry Expert Q&A, Market Leaders Buyer’s Guide, and More page 56

2 Case Studies

Innovatix and Temptime

I M P R O V I N G PAT I E N T CARE & PHARMACY COST CONTAINMENT

E D I T I O N

Innovatix and Temptime

2021 CIRCULATION

Issue Focus: Retail, Specialty, & LTC Issue Frequency: Spring, Fall, & Winter Circulation Per Issue: 26,500+ 18,000+ Owners (Independents) 1,500+ Long-Term Care Pharmacies 2,500+ Retail Chain Executives 2,500+ Industry Executives 2,000+ Trade Show Handouts

SUMMER 2021

I M P R O V I N G PAT I E N T CARE & PHARMACY P R O F I TA B I L I T Y

WINTER 2021

Waste Management, Veltek Associates, Inc., Culturelle, IMI, Azina, Modular Devices Inc., and More

Issue Focus: Hospital & Infusion Issue Frequency: Summer & Winter Circulation Per Issue: 12,200+ 6,500+ Hospital Directors 2,200+ Clinical Consultants 2,500+ Industry Executives 1,000+ Trade Show Handouts

Spring 2021

Summer 2021

WINTER 2022

IENT PAT I M P R O V I N GI M P R OCV Y A I N G PAT I E N T A RA M CARE & P HC RE & B I L I T YP H A R M A C Y P R O F I T ACOS T CON TAIN MEN T

H E A L T H

S Y S T E M

I N F U S I O N

E D I T I O N

20 Unique Products & Services

Spring 2021

Community • Specialty • LTC

20 Unique Products & Services

Discover 20 products and services that will help your pharmacy improve patient care or contain costs.

Discover 20 products and services that will help your pharmacy improve patient care or increase profitability.

Environmental Monitoring Industry Expert Q&A, Market Leaders Buyer’s Guide, and More page 52

Drug Distributors & Wholesalers Industry Expert Q&A, Market Leaders Buyer’s Guide, and More

4 Case Studies

Leiters, Stericycle, Shields Health Solutions, and Visante

IMPROVING PAT I E N T C A R E & PHARMACY P R O F I TA B I L I T Y

page 50

8 Thought Leader Videos

Celebrating 10 Years

Eight Video Series Including Micro Merchant Systems, SPARx, ARxIUM, and Mission Critical Delivery Solutions

page 28

First Financial Bank Case Study First Financial Bank PPP Loan Supports Creekside Pharmacy During Pandemic page 38

RXinsider Reflects on the Past Decade With Helmer Scientific

Robert Fink, Pharm.D., MBA, FACHE, FASHP, BCNSP, BCPS Chief Pharmacy Executive ~ UofL Health, Louisville, KY

Health System • Infusion & Community • Specialty • LTC

Community • Specialty • LTC

Visit 20Ways ONLINE at RXinsider.com/20Ways

Health System • Infusion

Community • Specialty • LTC

OUR TEST, YOUR CURE . . .

ENSURING A H E A LT H Y WO R LD

ACC combi nes robust re a ge nt s, a na ly sis a nd techni cal s ervi ce exp e r t ise , t o prov ide y ou w it h div e r se s ol uti ons for e ndot ox in a nd gluc a n t e st ing.

Associates of Cape Cod, Inc.

Your Endotoxin & Glucan Experts A s s o c i a t e s o f C a p e C o d , I n c . - a S e i k a g a k u G ro u p C o m p a n y

MKT#21-107

MEDCOAT® is an amazing new product that will revolutionize the way you take medications. MEDCOAT® covers pills and capsules with a coating camouflaging the bad taste of any medicine. It’s sugar free and has no artificial flavors or colors added. This coating stimulates saliva production aiding in the swallowing process. The special coating applicator is easy to use and can work on any size shaped pill or capsule. MEDCOAT® alleviates the need of crushing tablets or adding flavoring which can alter medicines efficacy. NATURAL GREAT TASTE • MEDCOAT® covers pills and capsules with a coating camouflaging the bad taste of any medicine. • Sugar, Soy and Gluten Free • No artificial flavors or colors in MEDCOAT® Citrus lemon/lime or Strawberry flavors.

SAFETY • Contains only food ingredients that are not known to interact with drugs. • No known contraindications with any drugs. • Many pills should not be crushed and using MEDCOAT® will allow many patients to take the pill without the needing to do this first.

EFFICACY • Pills and capsules are covered in a slippery coating making it easy to swallow them. • Perfect for coating pills with sharp edges or ones that have been halved or quartered. • The special coating applicator is easy to use and can work on any size and shape of pill or capsule. • Alleviates the need of crushing pills or adding flavoring which can alter medicines efficacy. • MEDCOAT® dissolves quickly once swallowed.

ADDED BENEFITS • Helps patients take the right dose of their prescribed medications by alleviating the need to crush or cut pills. • Encourages patients to complete their prescribed and non-prescribed medicine regimens. • One MEDCOAT® applicator can coat up to three pills depending on the size. • Allows doctors to prescribe the pill version of a patient’s medication rather than the liquid form, which is often bad tasting and dosed improperly.

ORDERING INFORMATION Item Number

Product

1018514

Citrus Flavor (lemon/lime)

1018515

Strawberry Flavor

1018513

Cola Flavor

Call us today to place your order or for a free sample at 1-888-832-0322, M-F: 8:00 a.m. – 4:30 p.m. ET. www.medcoatusa.com.

WHY GUESS ON DOSAGE, JUST USE HURRICAINE ONE! An Innovative Non-Aerosol Unit Dose Topical Anesthetic Spray • Meets Joint Commission Standard for the most ready-to-administer form available.* 0.5 mL each

• Fast onset. Short duration. Virtually no systemic absorption. • Utilizes bar code medication administration (BCMA) to accommodate point-of-care scanning. • Virtually eliminates adverse events resulting from preventable medication errors, ensuring the “5 Rights” are met: √ Right Drug √ Right Patient √ Right Dose √ Right Route √ Right Time • Single unit-of-use packaging eliminates the potential for cross-contamination. • Increases billing accuracy and improves supply chain costs. *Joint Commission Standard: MM.05.01.11, EP4

ORDERING INFORMATION NDC#

0283-0610-11

0283-0610-26

AMERISOURCE BERGEN

10090081

10090082

CARDINAL HEALTH

CIN 4362547

CIN 4363370

MCKESSON

1410125

1411925

MORRIS & DICKSON

086611

086629

PRODUCT

HurriCaine ONE® Unit Dose Non-Aerosol Spray Box of 2, 0.017 fl. oz. (0.5 mL) each

HurriCaine ONE Unit Dose Non-Aerosol Spray Box of 25, 0.017 fl. oz. (0.5 mL) each

If HurriCaine ONE is not yet available through your wholesaler, request it by name and NDC Number.

MAKE THE SWITCH TODAY.

Call 1-800-238-8542 to place your order or for more information. www.beutlich.com HurriCaine ONE is a registered trademark of Beutlich® Pharmaceuticals, LLC. MCHC1 879 1021

REDEFINING THE RETURNS INDUSTRY The value of doing business with GRx far exceeds the industry standard. GRx offers a full suite of comprehensive business solutions and advanced data intelligence for pharmacy customers. INDUSTRY EXPERTS

35 years of industry experience as a leading returns service provider

ADVANCED ANALYTICS

Dynamic data analytics providing revenue producing strategies

VALUE THROUGH SERVICE

Brings financial optimization to the pharmacy to exceed its business goals

COMPLETE TRANSPARENCY

Fully transparent credit reconciliation with no hidden fees

SERVICE OPTIONS

World class onsite or mail in service available nationwide

Call or visit us online:

1.800.473.2138 | GuaranteedReturns.com 100 Colin Drive, Holbrook, NY 11741 | Email: info@guaranteedreturns.com

K IN STOC NOWINE

1 to 46 cu.ft.

C FOR VACAGE STOR

Advanced Temperature Control

Intelligent microprocessor controls with a 2-8ºC range & +/-1ºC variation

Fast Temperature Recovery Optimized forced air cooling

Built-In Display

Multiple Alarms

Trusted Security

Antimicrobial Handles

EcoFriendly

Digital display of the current & high/low temperature with a buffered temperature probe

Audible alerts for temperature spikes, door open, & power failure

Keyed or keyless locks

Flexible Interior

DDLReady

ADA Height Option

Ventilated drawers, interior lockers, or adjustable shelves

Access port & remote contacts allow easy connection to external logging systems

32” high choices for use under lower ADA compliant counters

Silver ion coating to reduce the spread of germs

Uses environmentally-friendly hydrocarbons for a greener footprint

Accucold products are available through a host of high quality dealers To discuss your storage needs, contact our product specialists: Ike Goldstein 1.888.4.MEDLAB ext. 204 ikeg@accucold.com

Christian Geddes 1.888.4.MEDLAB ext. 268 christiang@acccucold.com ACCUCOLD DIVISION FELIX STORCH, INC. ISO 9001:2015 CERTIFIED 770 Garrison Avenue, Bronx, NY 10474 USA • TEL 1.888.4-MEDLAB FAX 844.478.8799 • info@accucold.com • accucold.com

Contents DRUG DIVERSION

American Health Packaging, Offering A Broad Portfolio Of Barcoded UnitDose Products

Now Available from American Health Packaging As a leading manufacturer of serialized, barcoded unit-dose medications, our growing product formulary continues to support your patient safety and pharmacy efficiency initiatives. Review the most recent additions below, now available through partner wholesalers and GPOs. For the full product catalog, visit www.americanhealthpackaging.com.

Unit dose oral solids AB #

Cardinal Health #

McKesson #

Morris & Dickson #

Product description

Strength

UD size

NDC 11

10254220

3703665

2302917

981878

Budesonide Capsule (Enteric Coated)

3 mg

20 UD

60687-0596-32

612515

Calcium Acetate Capsule

667 mg

100 UD

68084-0479-01

981910

Famotidine Tablet

20 mg

100 UD

60687-0595-01

10124030

4907010

2027480

10254113

5703590

3790623

10260469

5740444

2349314

106591

Febuxostat Tablet

40 mg

30 UD

60687-0538-21

10258312

4149654

3274917

956623

Fenofibrate Capsule (Micronized)

200 mg

30 UD

68084-0329-21

10260081

5740352

2346641

104364

Fenofibrate Tablet

48 mg

30 UD

60687-0618-21

10258877

5728696

2334258

040410

Fenofibrate Tablet

145 mg

30 UD

60687-0629-21

10254284

5704143

3901725

982025

Fluphenazine HCl Tablet

5 mg

100 UD

68084-0846-01

3901741

982033

10252050

5688189

1584887

921783

Gabapentin Capsule

100 mg

100 UD

60687-0580-01

10252051

10254285

5688197

5704150

1584903

921791

Gabapentin Capsule

300 mg

100 UD

60687-0591-01

921817

Gabapentin Capsule

400 mg

100 UD

60687-0602-01

981886

Hydrochlorothiazide Tablet

25 mg

100 UD

60687-0593-01

10252014

5688205

1584911

10254190

5703012

2302966

Fluphenazine HCl Tablet

10 mg

100 UD

68084-0950-01

10258311

5724828

2329746

032094

Hydromorphone HCl Tablet (CII)

2 mg

100 UD

60687-0579-01

10258383

5724836

2329761

032110

Hydromorphone HCl Tablet (CII)

4 mg

100 UD

60687-0590-01

10254966

5709282

2303436

10261602

5743703

2358067

109579

Lorazepam Tablet

2 mg

100 UD

60687-0649-01

10260085

5736483

2343838

103572

Omeprazole DR Capsule

40 mg

100 UD

60687-0608-01

10258394

4858015

2016327

257253

Potassium Chloride ER Tablet

10 mEq

100 UD

68084-0632-01

5728688

2333243

039784

Propranolol HCl Tablet

10 mg

100 UD

60687-0587-01

10258893 10254155

5703574

045013

Ketorolac Tromethamine Tablet

10 mg

3691490

981803

10254131

5703582

3693793

981845

Rifampin Capsule

300 mg

100 UD

60687-0586-01

5726450

2329555

035055

Ropinirole Tablet

0.25 mg

100 UD

60687-0577-01

10258196

5726468

2329571

035220

Ropinirole Tablet

1 mg

100 UD

60687-0588-01

10260130

5736178

2343168

102426

Sennosides and Docusate Sodium Tablet

8.6 mg / 50 mg

100 UD

60687-0622-01

5728233

2333557

10258623

10258624

5728241

2333581

5728258

2333649

10259425

5731617

2338465

039560

150 mg

Valsartan Tablet

039602

40 mg

Valsartan Tablet

039594

Valsartan Tablet

114736

30 UD

60687-0104-21

10258214

10258635

Rifampin Capsule

30 UD

Valacyclovir Tablet

30 UD

60687-0575-21

60687-0612-21

80 mg

100 UD

60687-0623-01

160 mg

100 UD

60687-0634-01

500 mg

30 UD

68084-0215-21

Liquid unit dose AB #

Cardinal Health #

McKesson #

Morris & Dickson #

Product description

Cup delivery

Cup strength

Pack size

10260982

5742325

2354959

108985

Acetaminophen Oral Solution

10.15 mL

325 mg / 10.15 mL

100 ct

60687-0571-56

NDC 11

10260983

5742333

2354967

108993

Acetaminophen Oral Solution

20.30 mL

650mg / 20.30 mL

100 ct

60687-0571-37

10249925

5676135

1574276

914382

Atovaquone Oral Suspension

5 mL

750 mg / 5 mL

42 ct

60687-0534-78

10261209

5743026

2356897

109017

Hydromorphone HCl Oral Solution

5 mL

5 mg / 5 mL

30 ct

60687-0566-86

10258469

5725668

2328805

034397

Midazolam HCL Syrup (CIV)

2.5 mL

5 mg / 2.5 mL

30 ct

60687-0576-10

10258500

5725676

2328821

034371

Midazolam HCL Syrup (CIV)

5 mL

10 mg / 5 mL

30 ct

60687-0576-86

10251651

5699970

3579828

971820

Milk of Magnesia Saline Laxative (Magnesium Hydroxide)

30 mL

2400 mg / 30 mL

100 ct

60687-0429-76

800.707.4621 americanhealthpackaging.com

Hitting the mark

AHP unit dose simplifies one of the most complex parts of your job – reliably obtaining ready to dispense medications – in a format that promotes positive outcomes for your patients.

AD202110-0093

Case Study: UofL Health and Medacist — Decision-Making for Drug Diversion

C ASE ST U DY

Decision-Making for Drug Diversion A Leadership Guide to Procuring a Drug Monitoring System BACKGROUND UNIVERSITY OF LOUISVILLE HEALTH (UofL Health) is a fully integrated regional academic health system with five hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehab Institute, and Brown Cancer Center.

INTRODUCTION Robert Fink, Pharm.D., MBA, FACHE, FASHP, BCNSP, BCPS Chief Pharmacy Executive ~ UofL Health, Louisville, KY

With a responsive line of barcoded unit-dose oral solutions, a growing liquid unit-dose offering, as well as individually wrapped inhalants, American Health Packaging continues to support pharmacy efficiency.

A leadership guide to procuring a drug monitoring system.

This case study examines executive decision-making regarding drug diversion at UofL Health. The study profiles Robert Fink, the chief pharmacy executive, who provided insight into leadership’s recent decision to purchase a system to elevate detection and eliminate diversion. “We consider a single dose a loss, and we have no tolerance for not knowing where that dose went,” said Fink. “We are always in a mindful, vigilant state as we can’t have anyone impaired working with a patient. We will investigate every loss in an extremely fair and thorough way.” The system-wide Drug Diversion Response Team at UofL Health has three components. The first is an executive committee comprising Fink; Shari Kretzschmer, senior vice president and chief nursing officer; and Shelly Denham, senior vice president of compliance, risk and audit services. The triad reviews each case, and at least two of three must be involved in any investigation to eliminate unilateral decisions. Secondly, a broader diversion team exists managed by a nurse solely dedicated to investigations who reports to the pharmacy manager responsible for regulatory and accreditation compliance for the entire system. They are the daily users of the monitoring system, conducting audits and surveillance. If an investigation is needed, they collaborate with the pharmacy manager, nurse, and HR business partner at the specific location with oversight from the executive committee. The third entity involves a large multidisciplinary committee comprised of physicians, nurses, pharmacists, and HR business partners from every location. They have insight into investigations and approve policies and procedures and quality assurance programs. Each member of a diversion team brings a unique skill set and perspective to the overall program. Tom Miller, CEO of UofL Health is ultimately responsible for all controlled substances in the health system. As head of pharmacy services, Fink quarterbacked the rigorous process to choose a drug diversion system, and together with the chief medical officer, made the final decision.

INTENDED OUTCOME www.medacist.com

UofL Health’s purpose is to provide a culture of exceptional care and achieve the highest standards of quality and safety. Mitigating drug diversion is critical to accomplishing the mission of the health system.

page 70-73

page 57

VERSI DRUG DI

Q&A Buyer’s Guide

ON Q&A

American Health Packaging 2550-A John Glenn Avenue Columbus, OH 43217 (800) 707-4621 americanhealthpackaging.com

GRx 100 Colin Drive Holbrook, NY 11741 (800) 473-2138 www.guaranteedreturns.com

Maxpert Medical 6106 Bausch Road Galloway, OH 43119 (866) 231-1222 Maxpertmedical.com

PharmID 2157 N. Northlake Way, Suite 230 Seattle, WA 98103 (206) 922-3589 Pharmid.com

American Rx Group 6321 Bury Drive, #19 Eden Prairie, MN 55346 (855) 269-1750 americanrxgroup.com

GTC Consulting 7603 Achterman Road Pleasant Plain, OH 45162 (513) 815-8779 www.gtcconsults.com

Medacist 1492 Highland Avenue, Unit 4/5 Cheshire, CT 06410 (866) 633-5393 www.medacist.com

Protenus 1629 Thames Street, 2nd Floor Baltimore, MD 21231 (410) 995-8811 www.protenus.com

ANiGENT 17736 Edison Avenue Chesterfield, MO 63005 (833) 264-4368 Anigent.com

national Inter Asteres Inc.

e John Burk NarcX President 523 E 1750 N, Suite 300 Vineyard, UTciati 84059 on Asso 307-2514 lity Diversion (800) Narcx.com

Health Care Logistics P.O. Box 25 Circleville, OH 43113 (800) 848-1633

Faci HealthGohcl.com

Rx Destroyer 701 Blackhawk Drive, Suite F Burlington, WI 53105 (888) 608-5160 RxDestroyer.com

identifyingReturns RxCarbon LLC National Pharmaceutical HelioMetrics responsible for is also then 4164 team, 1207 S. White Chapel NW Urbandale Drive 5000 W 36th Street, Suite 225 4110 Sorrento Valley Boulevard specialist the drug diversion the The diversion Boulevard, Suite 150B 50322 Minneapolis, MN 55416trends, notifyingUrbandale, IAtion San Diego, CA 92121 with diversion investiga potential incidents South Lake, TX 76092 (800) 470-7725 conducting (612) 444-3242 and conducting the (858)the 777-8600 think that y, this includes if applicable, (866) 436-9264 www.heliometrics.net www.asteres.com pharmacwww.NPReturns.com Q. Do you healthcare nursing and that can provide ion within assistance of and anyone www.rxcarbon.com of drug divers drug diverters Pharma Logistics Infinity Laboratories BD (Becton, Dickinson primary person off since fallen interviews of They are the and Company) medicati Rxpert Solutions 1801 W. Butterfield Road on 1585 South Perry Street, Suite B the incident. facilities have to mic? as involving ncies of the1pande Becton Drive diverted personnel Castleinsight 950 Boardwalk, Suite 305 Rock, CO 80104 resolving discrepa Libertyville, IL 60048 the advent tasked with re facilities Franklin Lakes, NJ 07417 San Marcos, CA 92078 (888) 729-7427 Most healthca drug diversion (303) 730-7330rations. not. y detecting Definitel administ and ng 847-6800 (201) (760) 705-4078 www.pharmalogistics.com of monitori of the COVID Infinitylaboratories.com round for a from the jobs bd.com/diversion the urgent needs www.rxpert.solutions the best backg to address isFacility list? Pharmacolog, Inc. International Health facility What their Q. specia in , Diversion Associationbe a diversion ist,1950 RxSafe CPS Solutions, LLC 150 N. Michigan Avenue, Suite a diversion specialist problem. a nurse, pharmac person to s are IL in place, 655was Metro Place S., Suite 450 specialist eitherP.O. Box 28 2453 Cades Way, Suite A Chicago, 60601 seen several been diversion that whatever likely have most I , means n. has This etc.,43017 technicia OH 45106 Dublin, y (708) Vista, CA 92081 359-7302 withBethel, Typically team, OH ing job. diluted. So, cases a pharmac and/or a diversion d(800) who do an outstand the very least (513) 623-3278 and in some (760) 593-7161 at968-6962 www.pharmacolog.com ns in this role the diverting eliminate or allows rily technicia it y tent, tempora Ihfda.orgpharmac www.cpspharm.com Rxsafe.com next to non-exis on. Pharmacyion Services Group team monitoring likely to divert medicati divers International Medicalexactly is a 77 Datarithm Stericycle Cypress Lane cause more latitude can even ic e What pandem employe Q. on?FL 32751 COVID Industries 7037 theRoad functi 2355 Waukegan Road Maitland, of Fly s, the g stress prior addiction 2981 Gateway how do they (407) 383-3301 , or13057 andDrive The mere added the level of addressin East Syracuse, Bannockburn, IL 60015 divertingNY important to facility. tendency of very re is the team with Pompano A Beach, FL 33069 (877) 273-5112 those ons. (866) 783-7422 diversion within a healthca medicati problem PharmWaste Technologiesy and stealing (954) 917-9570 www.datarithm.co www.stericycle.com up of pharmac temptation of the drug diversion very least 3317made 109th Street, Suiteent, A legal, atory the Imiweb.com at mand is managem The team that theInc. EnlivenHealth, such as risk a Swisslog Healthcare Urbandale, IA 50322 think team, but if Q. Do you a controlled KeySourcenursing personnel. Others (515) a part of the 590 Middlefield Road loss of 11325 Main Street theft/ y a team of s, can also be 276-5302 ing obviousl resource is ented 7820 Palacehuman Drive report Mountain View, CA 94043 this person the Broomfield, CO 80020 exists, www.pwaste.com is being docum oftentimes be Cincinnati, OH 45249 specialist (800) 764-0300 diversion substance Enlivenhealth.co specialist will rities? diversion PharmaLink Inc. autho The state also. (800) 842-5991 think www.swisslog-healthcare.com don’t member to DEA and Euclid Medical Products ed above I #200 meeting. 8285 Bryan Dairy Road, assemble KeySource.com First, as mention familiar with diversion one to call the to be able to Largo, FL 33777 nts need No, I do not. 339 Mill Street called TouchPoint Medical l that are of participa typically signs personne team Masters Pharmaceutical OH 44606 200 Touchpoint Drive Diversion e and are (800) 257-3527 recognize the adequately trainedApple Creek,would unresolved thosePharma Way a very short timefram of 3600 facilities re(800) 727-2543 diversion or Odessa, FL 33556 www.pharmalinkinc.com within s, since many inside healthca there is an obvious designed to notify the (800) 947-3901 the incident/ Mason, OH 45036 when report www.euclidmedicalproducts.com together meeting is diversion and d. to discuss the www.touchpointmed.com (800) 982-7922 error. This been reassigne for the team medication people have . The manner and www.mastersrx.com list, diversion timely a drug in l team ion specia potentia of a bona resolving the a drug divers next steps in te after each incident Q. What is should debrief critiquing both he/she opera team incident, does diversion d. and how facility? T E M • I N F U S I O N diversion to examine the entire ent is warrante 62 W I N Thealth E R 2 0 2care 1 I H E A LT H S Y S is fide to monitor and where improvem within the whose job decisions good someone the is the by dpecialist d substances A diversion ration of controlle augmented daily, the administ employees. This is typically a re pinpointing can assist in institution’s healthca programs that re facility. by various software the healthca problem within drug diversion

WINTER

2021

H E A LT H

SYSTEM

O • INFUSI

Industry Expert Q&A, Drug Diversion Market Leaders Buyer’s Guide, and more.

Health Care Logistics® By Design — Real Solutions, Right Away

DROP BOXES... not winter burrows!

Customers achieve measurable results with high-quality cabinets and storage containers, functional equipment, and full-color graphics designed to their exact specifications.

GoHCL.com • 1.800.848.1633 11_21_RXInsider 20 Ways Winter HOSPITAL.indd 1

10/7/21 1:56 PM

page 58-61

FDA Registered | Iso Certified

Your partner in pharmacy compliance since 1992 USP <797> USP <71> USP <800> Left: GM7030 PATT2®, Personal Aseptic Technique test kit, 3mL ampules, 20mL vials, 100mL partially filled minibag. Below: ET1000 EnviroTest® TSA with Lecithin & Tween 80 growth media paddles for surface, air, or glove fingertip sampling.

Media Fill Hazardous Drug Handling Validation Surface and Fingertip Testing Sterility Testing Qimedical.com

DRUG DIVERSION

DRUG DIVERSION Buyer's Guide

DR UG DIVERSION

info@qimedical.com

Tel. 800.837.8361

Q.I. Medical, Inc.™ Your Partner in USP <797> Pharmacy Compliance Providing quality assurance products to hospitals and pharmacies practicing sterile compounding, with a singular focus on pharmacy compliance. Our long-standing regional distribution partners are able to provide exceptional in-person service and training.

page 75

Temptime Temperature Intelligence® Solutions — Monitoring Devices and Integrated Solutions for Medication Shipments, Storage, and Pharmacy Facilities

TEMPERATURE INTELLIGENCE®

Monitoring solutions to maintain the vaccine cold chain Get visibility into medication temperatures onsite and in transit Keeping refrigerated medication—including COVID-19 vaccines— within the right temperature range is critical for maintaining their efficacy. That’s why CDC guidelines recommend using digital data loggers to monitor temperatures as vaccines travel to patient administration sites. Temptime’s S-400 electronic temperature sensors capture the temperature data you need, 24/7, while also alerting you to excursions. Learn more about how Temptime can help you preserve valuable vaccine supplies and meet CDC guidelines: temptimecorp.com/vaccine-monitoring

Providing the devices and information to accurately monitor temperature-sensitive medications.

zebra.com | temptimecorp.com

ad-RXInsider-vaccine-distribution-winter-2021.indd 1

1/15/21 9:50 AM

page 77

page 67 DRUG DIVERSION

Visante — HighPerforming Pharmacy is Who We Are

Pharmacy consulting designed for optimal growth

We help you achieve extraordinary results in all areas of health system pharmacy

Strategic Planning & Implementation

Compliance that Improves Care

Financial Results

We collaborate with you to deliver innovative solutions that will elevate your organization to peak performance levels.

Our team of compliance experts will improve confidence, enhance care and ensure patient, worker and community safety.

Making the most of opportunities to manage costs and increase revenue is core to our consulting. We help you improve financial performance across your organization.

Visante consultants bring you expertise in all areas of hospital and health system pharmacy: • Comprehensive Strategic Assessments • 340B Program Solutions • Specialty Pharmacy Programs • Revenue Cycle and Drug Reimbursement Strategies

• Supply Chain Strategies • Drug Diversion Programs • Drug Compounding Excellence

Transforming healthcare through pharmacy.

We're in the business of advancing pharmacy. Our consultants work with hospitals and health systems combining a wealth of expertise with personalized and comprehensive support to optimize your pharmacy operations and deliver better patient care.

Case Study: Piedmont Healthcare and Waste Management’s PharmEcology® Services

C ASE ST U DY PIEDMONT HEALTHCARE AND WASTE MANAGEMENT’S PHARMECOLOGY® SERVICES COLLABORATE TO ENSURE USP <800> COMPLIANCE

OVERVIEW Back in 1905, Dr. Ludwig Amster and Dr. Floyd Wilcox McRae founded Piedmont Hospital. At that time, they were considered pioneers in patient care, fulfilling the healthcare needs of patients all over Atlanta and surrounding communities.

Skip Lynch, RPh

Director Outpatient Pharmacy Services ~ Piedmont Athens Regional

Chelsea Parry, Pharm.D., BCPS Oncology Pharmacist Specialist ~ Piedmont West Infusion Center

Collaborate to ensure USP <800> compliance.

There is no question that Piedmont is committed to continuous improvement and making a positive difference in every life they touch. Building their reputation of excellence and enhancing services is a top priority. And this mission holds true with regards to hazardous waste and hazardous drug management. “When the USP <800> standards were first published, we wanted to comply on a system-wide level,” explains Skip Lynch, Piedmont’s director of outpatient pharmacy services. “So we searched for a solution that could serve our entire healthcare system. PharmEcology not only offered a comprehensive solution, but provided us with a very strong partnership that would allow us to meet our specific needs.” With the help of PharmEcology’s USP <800> Consultation Program, Piedmont is well on its way to protecting all healthcare personnel from hazardous drugs as well as ensuring a safe and healthy environment.

TACKLING CHALLENGES According to numerous studies, acute and chronic health effects can occur from occupational exposure to more than 200 hazardous drugs (HDs) commonly used in healthcare settings. As a result, the National Institute for Occupational Safety and Health (NIOSH) defined criteria for identifying these hazardous drugs. Based on this information, the United States Pharmacopeia (USP), an independent, scientific nonprofit organization, developed the USP General Chapter <800> standards for handling hazardous drugs to minimize the risk to public health. The goals of these standards include:

www.pharmecology.com

page 69

page 78-81 WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 15

CONSULTING WITH RESULTS Automated Dispensing Systems and Implementation Support RXinnovate is the industry leader with designing, building and implementing automation and technology for hospitals. RXinnovate provides the resources and expertise for these projects that impact patient care throughout the hospital. RXinnovate provides the vision and expertise for your Automated Dispensing System design, build and implementation.

Automated Dispensing Systems and Implementation • Formulary build • Data Analysis and optimization review for pre build of equipment • Drawer mapping for high use medications

7421 Monte Verde Lane West Palm Beach, FL 33412 Phone: (203) 494-1407

www.RXinnovate.com

• QA review of all equipment and medications pre implementation • Interface validation testing • System and workflow design • Medication optimization • Assigning and loading of all medications • Training and education • Implementation support for Pharmacy and Nursing • Project management • Post implementation optimizations

VACCINE COLD CHAIN STORAGE THAT’S A STEP ABOVE THE STANDARD • • • • •

Meets CDC guidelines and prepared for NSF 456 standard Blu-Wave® cooling technology for precise temperature uniformity Low cost of ownership Unique sizes, combinations and customizations Made in the USA since 1955

Vaccine safety and integrity are at the forefront of a patient’s well-being and health. Migali Scientific® has been manufacturing high-performance refrigerators and freezers since 1955. Our cutting edge Blu-Wave® cooling technology delivers rapid temperature recovery and uniformity, ensuring vaccine and medication safety and efficacy. Scan QR CODE to learn why more hospitals and practitioners are choosing Migali Scientific refrigerators and freezers.

Committed to Sustainability We plant a tree for every product sold www.migaliscientific.com/whymigali • 855.462.4254

FDA Registered | Iso Certified

Your partner in pharmacy compliance since 1992 USP <797> USP <71> USP <800>

Are you properly mimicking your

processes? Ask us about a custom media ﬁll solution for your facility.

Media Fill Hazardous Drug Handling Validation Surface and Fingertip Testing Sterility Testing

Qimedical.com info@qimedical.com Tel. 800.837.8361 FDA Registered ISO Certiﬁed

Returns Processing excellence for 340B covered entities!

Trained consultants to service Apexus 340B PVP Participants On-site and Mail-in Service Available Nationwide

SERVICING COVERED ENTITIES AND CONTRACT PHARMACIES OF THE 340B PRIME VENDOR PROGRAM (PVP) CONTRACT #PVSA2503

(800) 257-3527 / pharmalinkinc.com

PharmaLink understands the importance of compliance and record keeping as it pertains to the 340B Program. As an Apexus Contract Supplier for Pharmaceutical Return Services, we have developed an industry leading return processing system to specifically address the audit guidelines of the 340B Program. We’ve been providing returns services to Apexus participants since 2016. Call today to see how simple we can make your next return. Provide reference code “PRIME” to unlock premium returns service exellence!

“

PraxiJect ™ SF 0.9% NaCl Prelled Syringes

Precise graduation

Syringes that set the standard for quality and safety

”

Take a closer look at all the benets a PraxiJect™ SF 0.9% NaCl prelled syringe oﬀers you.

Color coded cap and label

PraxiJect™ SF 0.9% NaCl prelled syringes set the standard for quality and safety. No other company oﬀers you all these advantages in a cost eﬀective product. Manufactured according to internationally

Respects ISO specication

Pharmaceutical grade plunger

recognized technical standards, current Good Manufacturing Practices and ISO 13485 Quality Management System requirements. Discover the advantage many of the largest hospital institutions have realized work best for them.

Features & Benets Zero reux design

Designed for use in a sterile eld Precise graduations Meets USP specications Latex and preservative free Screw on luer lock cap for additional safety Terminal sterilization, provides the highest degree of sterility available Easy glide piston. No lock eﬀect or inadvertant solution leaking during priming.

INNOVATING FOR HEALTH

Praxiject.com

Contents Trusted Hospitals Rely on ISO-MED

Trusted Hospitals put their trust in

Comprehensive environmental monitoring is critical to a hospital’s ability to earn trust in its adherence to safety protocols. ISO-MED is your trusted partner in that effort, with a full range of products that not only maintain a sterile cleanroom, but test for compliance with a clean compounding environment.

Why ISO-MED? We’ve been a trusted hospital supplier for over a decade with our solid combination of quality, selection, service and convenience.

Order online:

iso-med.com

Call for fast reordering:

800-797-1405 1220 Graphite Drive, Corona, CA 92881 USA | 800-797-1405 | sales@iso-med.com | www.iso-med.com

Unit Dose Done Right

Medi-Dose, Inc./EPS, Inc. Delivers Bar Coding, Packaging, and Labeling Pharmacy Solutions

Unit Dos e, Bar Cod ing,

Pharmac • Cold Seal Nursing y & Supply • Tamper-Evident Experts! • Moisture Resistant • Ultraviolet Inhibitant • Reduces Cross Contamination • Ideal for Meds Covered by USP 800 • 6 and 12-month Beyond-Use Dating • 1-D and 2-D Bar Coding • Flexible Label and Report Formatting • Multiple Sizes and Shapes to Fit Your Meds & Storage Needs

Brightly Colored Labels Call Attention to Meds Requiring Special Handling

Scan QR Code for more information and pricing.

Simple. Reliable.

800.523.8966

MediDose.com

Unit Dose Done Right P 8.5 x 11.indd 1

6/1/20 2:02 PM

page 83 DRUG DIVERSION

With the Right Reverse Distribution Partner

What Can Pharma Logistics Do For Your Hospital? At Pharma Logistics we honor the challenges of today’s pharmaceutical market and provide our customers with a full-service reverse distribution experience that is focused on ease of use, regulatory compliance and financial accountability. When you partner with Pharma Logistics, you get access to: Build business intelligence.

Precision Reporting

With access to customizable and dynamic enterprise-wide reporting, our online Customer Portal drives process improvements through efficient and effective data reporting tools to help you build business intelligence and make better decisions. clean

Support at every step.

Dedicated Support Team

Your Customer Advocate’s focus is to support you through the implementation of services by offering a unique combination of quality service, partnered with industry leading software to help you reduce the volume of returned goods while making you more cost-efficient and profitable.

Guaranteed credits.

Credit Assurance

Our Service Fee Guarantee ensures our customers receive the service and credit rate expected.

collect

comply

Pharma Logistics brings efficiency and 24/7 visibility to the returns process so you can focus on patient care and the community. Call 888-729-7427 or visit www.pharmalogistics.com.

Receive credit in 14 days.

Expedited Cashflow

Our Rapid Credit Program offers customers a cost-effective solution AND delivers credits within 14 days from when the product is received in our warehouse compared to the industry standard of 12+months.

C AS E S T U DY CLINICALLY STUDIED CULTURELLE ® BENEFITS PATIENTS AND MAKES FINANCIAL SENSE SUMMARY

Pharmacists at health systems and long-term care facilities can now include on the pharmaceutical protocol the most clinically studied probiotic for patients experiencing: • Antibiotic associated diarrhea • Acute-infectious diarrhea • Traveler’s diarrhea Numerous human clinical trials have shown that supplementation with Lactobacillus rhamnosus GG, delivered in many Culturelle® dietary supplement products from i-Health, a division of DSM, significantly benefits the patients with these conditions.

Margaret Haldeman, Ph.D. Global Research & Development, Probiotics ~ i-Health, Inc.

page 93

Pharma Logistics Delivers Credit, Compliance, and Convenience to Improve Profitability

Improve Your Hospital Pharmacy Business

Recently renamed Lacticaseibacillus rhamnosus GG,1 Lactobacillus rhamnosus GG is still commonly referred to as Lactobacillus GG. Clinical data demonstrates that Lactobacillus GG reduces diarrhea resulting from travel to foreign countries,2, 3 side effects of antibiotics,4-9 and dysbiosis due to viral and bacterial intestinal infections,10-12 including Clostridium difficile infection.13-15

Trade Show & Meeting Calendar

Your reliable partner in pharmaceutical reverse distribution. Our Rapid Credit, Onsite, and Box and Ship services ensure hospital and pharmacy organizations can optimize inventory and supply chain.

page 85

page 94-99

Case Study: i-Health and Culturelle®

Sentry Data Systems, a Craneware Company — Expect More With a Trusted 340B Leader

As many as

76%

Clinically studied Culturelle® benefits patients and makes financial sense.

of pharmacy claims require intervention

Claims Manager Plus This sophisticated pharmacy claims solution automates the process

A pioneer in providing automated technology solutions that help providers manage 340B compliance, produce better quality, reduce the total cost of care, and reach more underserved patients.

of claim intervention to help you streamline claims processing while managing complex reporting requirements. And the savings potential is significant:

This unit-dose hospital pack under the brand of Culturelle® comes with the reassurance for the pharmacist and physician that they are prescribing the most extensively studied probiotic strain since its identification in 1985. The outcome is that the patients feel better quickly, physicians see that the overall digestive system is working better, and pharmacists provide a clinically studied strain. The purchasing officer also recognizes the value and quality of the Culturelle® suite of products. Overall, Culturelle® products may contribute to improved patient care and pharmacy efficiencies.

432

$14M

Average hours saved per employee per year

Average total cost savings per year

DATA-DRIVEN DECISION MAKING FOR PHARMACIST & PHYSICIAN Pharmacists play a crucial role when they are counseling physicians on options for patients experiencing digestive conditions. One of the more common health problems for physicians to address is when they prescribe antibiotics to heal a bacterial infection. The antibiotic often affects the balance of gut microbiota, causing distressing diarrhea. Furthermore, studies have shown that antibiotics can disturb the microbiome for up to one year.16, 17

Let Claims Manager Plus help you close the gap. For more information or to schedule a demo, visit sentryds.com/closingthegap

Clinical research indicates Lactobacillus rhamnosus GG reduces diarrhea and minimizes the adverse effects of the antibiotic.4-6 With this medical knowledge, pharmacists can provide the physician with data on why prescribing a probiotic is safe and effective. The findings also support that Lactobacillus GG, delivered in many Culturelle® products, helps with nausea, taste disturbances, and bloating, all side effects that can contribute to non-compliance.

Together, We are

When pharmacists and physicians join other colleagues on the Pharmacy and Therapeutics (P&T) committee to add to their www.culturellehcp.com

page 101

page 86-89 CLH_Ad_OneContainer_012220.pdf

1/22/20

4:35 PM

The Solution to Prevent Pharmaceutical Waste from Winding Up Here.

Simple. No worries. The highest level of technology. Best of all — full compliance.

Clinicians simply put both the non-hazardous and the RCRA hazardous pharmaceutical waste in the same black container.* Clean Harbors, the largest hazardous waste incineration company in North America, will pickup, transport and dispose your pharmaceutical waste, while keeping you fully compliant. We handle every step of the process. Because we own several proprietary incinerators, we do not require the same segregation as other providers.

CMY

Are you prepared for changes to subpart P in the EPA’s hazardous pharmaceutical regulations? Ensuring compliance with waste segregation protocols can be difficult, both to train and enforce, putting your facility at risk for non-compliance. * Due to DOT regulations, there are certain waste items that must be collected separately.

For more information: 855.MED.WSTE (633.9783) or healthcareservices@cleanharbors.com, healthcare.cleanharbors.com

Clean Harbors — Experts in Pharmaceutical Waste Disposal and Environmental Services

Here to help keep your healthcare facility in compliance with complex state and federal regulations — while managing your environmental and waste disposal needs from beginning to end.

DRUG DIVERSION

OneContainer®

Improve your Solid Oral Unit Dose needs with our comprehensive Bar Coding, Packaging, and Labeling Solutions — designed by healthcare professionals, for healthcare professionals.

BoxPicker® Automated Pharmacy Storage System From Swisslog Healthcare Creates a More Efficient Pharmacy Workflow

Reach Higher Standards of Care Humber River Hospital prioritizes quality care delivery through industryaccuracy, and safety measures. Swisslog Healthcare plays a key role in delivering this vision. Our solutions streamline pharmacy operations.

Our PillPick® Automated Packaging and Dispensing System and BoxPicker® Automated Pharmacy Storage System allowed Humber River Hospital realize:

Optimize pharmacy workflows with the market’s proven robotic storage and retrieval system to virtually eliminate picking errors, increase efficiency, and improve medication safety.

Reduced — Medication picking errors by more than 50% — Pharmacy technician labor to pick and package unit dose medications by more than 30% Gained — Pharmacy technician time for medication reconciliation and other direct care activities Increased Inventory control by

Realize your vision. swisslog-healthcare.com/humberriver-rx

approximately 30%

swisslog-healthcare.com/humberriver-rx

page 103

page 91

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 21

Expert Products For Expert Care®

Specialty Medication Preparation & Medication Safety Products

RESPONSIVE TO YOUR NEEDS FAST ORDER SHIPPING EXPERT PRODUCTS EXPERT SERVICE

CONNECT WITH US: (866) 231.1222 | MAXPERTMEDICAL.COM | INFO@MAXPERTMEDICAL.COM

Contents C AS E S T U DY

THE CAP THAT PROTECTS CHILDREN Prep-Lock™ Tamper Evident Caps Deter Drug Diversion INTENDED OUTCOME

The theft of controlled substances or other medications meant for the patient can occur at various points in the supply chain. The installation of drug security methods at healthcare facilities continues to increase each year because of the rise and risk of drug diversion. Mitigating diversion is a priority for every health provider, and ensuring patient safety is the goal of every drug diversion method.

Julie Lasseigne, PharmD Pediatric Pharmacy Director ~ Children’s Hospital of Alabama

This case study examines why one of the simplest drug diversion solutions is also one of the most successful. Tamper evident caps are an effective tool in addressing drug diversion. Specifically, this analysis details why this product works for Children’s Hospital of Alabama (Children’s). The success story became evident when Children’s converted to the ENFit Connector Standard to reduce enteral tubing misconnections. This conversion opened the opportunity for pharmacy leadership to purchase and prioritize tamper evident caps for the ENFit syringes, adding additional protection to the medication and Children’s.

BACKGROUND

Case Study: IMI and Children's of Alabama — The Cap That Protects Children Prep-Lock™ Tamper Evident Caps deter drug diversion.

ZERO PROBLEMS; ZERO COMPLAINTS

Northwell Health relies on Modular Devices Inc.

Northwell Health Relies on Modular Devices Inc. BACKGROUND AND INTENDED OUTCOME Northwell Health is New York state’s largest healthcare provider. It compasses 23 hospitals, 74,000 employees, and more than 700 outpatient facilities. The vast integrative healthcare network continually expands and upgrades facilities to improve the health of the patients and communities it serves.

Alfonso Traina Vice President of Cleanrooms ~ Modular Devices Inc.

In the fall of 2019, Northwell leadership assigned specific areas for upgrading, including the compound pharmacy in their Staten Island hospital. Great care and concentration had to go into the decision because of the protections needed for the life-saving work performed in this lab. This location serves cancer patients who need individualized chemotherapy. Disruption for these patients and the more than 1,000 daily hazardous and traditional intravenous (I.V. medications) produced in this lab was not an option during construction. Leadership landed on bringing in a vendor with a trailer that could convert into a lab. However, this trailer-chemotherapy lab had to come with an immaculate level of cleanliness. The mobile cleanroom had to provide incontestable evidence that it would be particulate-free and sterile to compound hazardous and non-hazardous pharmaceuticals and provide ample protection for staff and patients.

Otto VonEilbergh Director, Capital Projects, Corporate Facilities Services ~ Northwell Health

This 14-year employee knows the pharmaceutical needs of Children’s. And the hospital needed tamper evident caps for their pharmaceutical security program.

Equally as necessary, the self-contained unit had to ensure continuity of care. Tight timelines and stringent compliance were priorities. And a vendor had to assure seamless operations among logistical, productions, and entry requirements. This case study analyzes the hospital leadership’s decision to contract with a vendor to lease a cleanroom. It examines the criteria applied to choose a vendor and how the vendor addressed the challenges, complexity, and requirements of installing and servicing a modular relocatable compound pharmacy.

THE CHALLENGE

“If the employee is having a bad day and feel like they need the drug, we want them to see that cap and think that it’s not worth taking it. The cap signals not to make that bad choice because you’ll get caught,” said Lasseigne.

Construction is disruption, which is an anathema for a hospital. Leadership at Northwell Health wanted a short lead time to open a modular lab, while upgrading facilities. Beyond all the regulatory requirements that they must meet, the facilities staff wanted an environmentally friendly lab that minimizes a carbon footprint.

CHALLENGES

Drug diversion presents numerous safety and reputational risks for a hospital. Financially, hospitals bear the cost of diverted drugs, internal investigations, and follow-up care for affected patients. The government can fine the facility in excess of $4 million for inadequate safeguards.1 By their daily access to controlled substances, it is estimated that 15%

Otto VonEilbergh, director, capital projects, corporate facilities services, Northwell Health, now knows first-hand all the intricate details of moving a unit that is 14 feet wide and 60 feet long and

www.imiweb.com

www.portable-cleanroom.com

DRUG DIVERSION

Increase Safety in Your Hospital and Community Stericycle’s CsRx containers mitigate drug diversion in your hospital. Our MedDrop collection kiosks and Seal&Send envelopes TM

provide your patients and community safe solutions to dispose unused medications. SafeDrop provides safety and efficiency to TM

your immunization program and patients’ home injection therapies.

Comprehensive Regulated Waste Management

Case Study: Zero Problems; Zero Complaints

C ASE ST U DY

We protect what matters.

for your Pharmacy

CsRx Controlled Substance Waste Service • Heightens your organization’s drug diversion program • Deactivates controlled substance wastage

Seal&Send Medication Envelopes and MedDrop Drug Collection Kiosks

SafeDrop Sharps Mail Back Containers

• Increases your organization’s community stewardship

• Cost-effective and convenient

• Mitigates drug diversion in your community

• FDA and DOT compliant, USPS approved

• Protects the environment, keeping drugs out of waterways • DEA compliant

page 104-107

page 112-115

Safeguard Your Organization, Community, and the Environment With Stericycle Solutions

Download the 20Ways App

RXinsider.com/20ways

Stericycle’s CsRx Controlled Substance Waste Service can serve as a central component to prevent drug diversion in your hospital.

page 109 DRUG DIVERSION

CPS Partnerships to Drive Pharmacy Performance Excellence Tailored solutions. Proprietary tools. Extensive expertise.

For healthcare leaders who seek a partner in driving performance excellence, CPS delivers partnerships that drive financial, operational, and clinical success through the pharmacy.

Pharmacy Management

Specialty and Ambulatory Pharmacy

We empower healthcare organizations to advance the standard of care by: •

Implementing best practices and proprietary technologies to drive value and enhance the patient experience

•

Leveraging a deep bench of subject-matter experts

•

Continually improving the way healthcare is delivered

•

Driving performance to reduce costs, increase revenues, and elevate the status of internal leaders and teams

Let’s discuss opportunities to improve the financial and clinical performance of your pharmacy.

Pharmacy Consulting

340B Program Solutions

Telepharmacy

Supply Chain and Materials Management

CPS partnerships empower hospitals and health systems to advance the standard of care by elevating the performance capabilities of their pharmacy leaders and teams.

PT, OT, ST Rehabilitation

contactus@cpspharm.com • 800.968.6962 • www.cpspharm.com

03876-20 Winter Ways Fall - FP Ad and Profile_F.indd 1

10/6/21 11:47 AM

page 111 PUBLISHER RXinsider, LTD RXinsider CEO: Gregory Cianfarani, RPh DESIGN AND PRODUCTION Design & Layout Multimedia Marketing and Operations

Lora Bourque Eric Simmons Samantha Roy Alexa DiLuca Kristin Fennessey

SALES AND BUSINESS DEVELOPMENT Chris Kolkhorst, Vice President chris.kolkhorst@rxinsider.com Shaun Russell shaun.russell@rxinsider.com Mike Rahme mike.rahme@rxinsider.com Matt Payne matt.payne@rxinsider.com Jillian Melly jillian.melly@rxinsider.com Email sales@rxinsider.com Toll-Free Phone 800.972.2083 Fax 646.329.9766 Website www.RXinsider.com

20Ways is an official publication of RXinsider

NOTICE OF POLICY 20Ways is published quarterly by RXinsider LTD, 1300 Division Road, Suite 103, West Warwick, RI 02893. Postmaster: Send address changes to 20Ways/RXinsider, 1300 Division Road, Suite 103, West Warwick, RI 02893. Notification of address change must be made six weeks in advance, including old and new address with zip code.

GENERAL SUBSCRIPTION INQUIRIES RXinsider LTD c/o 20Ways 1300 Division Road, Suite 103 West Warwick, RI 02893 20Ways Online: www.RXinsider.com/20Ways General Information: 20Ways@RXinsider.com Circulation: See page 9

Editorial – views expressed in articles or profiles in the 20Ways are those of the author(s) and do not necessarily reflect the policies and opinions of RXinsider, our editorial board(s), our advisory board(s), or staff. Advertising – products, services, and educational institutions advertised in 20Ways do not imply endorsement by RXinsider. Copyright © 2021 RXinsider LTD. All rights reserved. Reproduction without permission is prohibited.

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 25

CUSTOMIZED USP <797> PRODUCT TESTING & E N V I R O N M E N TA L MONITORING

Sterility Testing Particulate Testing Endotoxin Testing Compliance On Demand™ Kits

EMPQ Validated Potency Testing Environmental Monitoring

element.com contact.us@element.com +1 888 786 7555

WE HELP YOU TURN YOUR IDEAS

INTO REALITY Founded in 1970, Uniweb’s expertise is the design and manufacturing of quality fixtures that go beyond the retail pharmacy doors. Whether it is new construction, relocation or a renovation, Uniweb offers a complete line of fixture solutions and dedicated designers to guide you through the process.

Our TEAM For over 50 years, Uniweb has helped retailers improve their existing space by re-imagining their approach and employing our high-density fixture line. Uniweb RX systems hold up to 50% more product storage in the same footprint over conventional stick-built systems, generating more profit to the bottom line! Uniweb manufactures modular rooms, wall storage panels, retail displays, RX fixtures, OTC options, counters, locking units and adjustable height workstations. Uniweb products provide unlimited flexibility, and unmatched strength, utility and appearance, at an affordable price.

Our ADVANTAGE

Corona CA 800.486.4932

uniwebinc.com

Uniweb has maintained a 10 day build-time for standard equipment and 4-6 week production for custom RX equipment and modular rooms. Uniweb delivers significantly shorter lead times, adaptable designs, and long-lasting products. Uniweb has maintained a lower surcharge, passing those savings on to our customers.

Uniweb Does it ALL! DESIGN * CRAFT * SHIP * INSTALL!

Methylprednisolone Acetate Injectable Suspension

Available Now from Amneal Pharmaceuticals

Because consistent supply is what you Demand. Our ever-expanding portfolio includes new dosage forms and complex injectables that you can count on. We take pride in delivering vital medicines like Methylprednisolone Acetate Injectable Suspension, USP into the hands of those who need them most. When they need them most. With over 250 generic products, we provide customers and patients with value, true accessibility, and quality. This is how We make healthy possible.

Methylprednisolone Acetate Injectable Suspension Pack NDC

Dosage Strength

Pack Size

70121-1573-01

40 mg/mL

1 mL Single-Dose Vial

70121-1573-05

40 mg/mL

25 x 1 mL Single-Dose Vials

70121-1574-01

80 mg/mL

1 mL Single-Dose Vial

70121-1574-05

80 mg/mL

25 x 1 mL Single-Dose Vials

Not made with natural rubber latex

Preservative free

Order from your wholesaler/distributor or contact Amneal: 866.525.7270 or CustomerRelations@amneal.com

Made For You The Arisure Closed System Transfer Device is designed to protect you and your team from exposure to harmful vapors when compounding, transporting, and delivering hazardous drugs. Arisure has received ONB clearance from the US FDA for its use as a Closed System Transfer Device (CSTD). 1. Mechanically and Microbiologically Closed 2. Needle-Free and Easy to Use 3. Minimal Workflow Disruption

13MM, 20MM, 28MM

C LOS E D M A L E LU E R

Arisure Closed Vial Adapter

WITH CAP

VA LV E

YM-050

YM-058

YM-004

Case Quantity: 100

YM-051, YM-053, YM-054 Case Quantity: 50

FEMALE NEUTRAL

ARISURE DRY SPIKE

Exclusive Distributor: Progressive Medical, Inc. (PMI) 997 Horan Drive • Fenton, MO 63026 Ordering Information: Tel: 314.961.5786 • Fax: 314.961.4535 cs@progressivemedinc.com • progressivemedinc.com

USP <800> RESOURCES Leading Pharmacy Suppliers of USP <800> Compliant Solutions These leading pharmacy suppliers offer product and service solutions to help your pharmacy and/ or cleanroom achieve USP <800> compliance. Contact these companies directly for more details on how they can help you meet the mandate of USP <800> compliance.

www.RXinsider.com/USP800

Rees Scientific

PHARMECOLOGY®

Innovative. Dedicated. Proven. Your true partner for 340B program administration and compliance.

Results you can believe in.

Verity Solutions® is a recognized leader in 340B program optimization. We drive continually improved solutions and vigilantly address regulatory changes so that our customers can dedicate fewer resources to program administration and more resources to community wellness. Partner with us to simplify 340B program management, confidently optimize federal pricing benefits, and benefit from the knowledge and support of our expert team.

1.800.581.1378 info@verity340b.com www.verity340b.com

VER ITY 340B ® SPL IT BI L L I NG | C O NTRACT PHARMACY SP ECIALTY C ONTRACT PHARMACY | C O M P LIANCE MANAGEMENT | P U RCHASE ANALYTI CS | VHUB ®

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Verity Solutions — Invested in Your 340B Program Success Partner with us to simplify 340B administration, confidently optimize federal pricing benefits, and benefit from the dedication and knowledge of our expert team. CEO:

George Puckett Founded: 2015 Employees: 100 Toll-Free Phone: (800) 581-1378 Phone: (425) 947-1922 Address: 12131 113th Avenue NE, #200 Kirkland, WA 98034 Website: www.verity340b.com

Company Background Verity Solutions is a leader in 340B program administration. Recognized as Best in KLAS: 340B Management Systems for the last four years, our mission is to make every aspect of 340B program management clear and easy to understand. We believe in optimizing program benefits through predictable automation and outstanding support so that every customer can maximize their savings. Hundreds of integrated healthcare systems, acutecare hospitals, community health centers, federally qualified health centers, pharmacies, and other 340B-eligible covered entities throughout the United States rely on Verity 340B® software and services to successfully manage their 340B program. Product Overview Our powerful V340B® cloud-based software platform provides comprehensive solutions for split billing, contract pharmacy, specialty contract pharmacy, compliance management, purchase analytics, and pharmacy network management (VHUB®). Our depth of in-house technical and software development resources and our highly skilled account management team are closely aligned to adapt as changes arise in the 340B program swiftly. We offer: • Agile Software Platform: Built and deployed with security, performance, scalability, and agility as primary goals. The Verity 340B platform is HITRUST certified and HIPAA compliant. • Intuitive Application: Designed with our users in mind, we maintain ongoing feedback and collaboration with our clients. This collaboration steers our continual software and services development.

What Sets Verity Solutions Apart? With increasing 340B regulatory complexity and demand for audit preparedness, it's more important than ever to have the right solution for your 340B program management — and the right partner. n Highlights • Industry leading core functionality of our V340B® platform with optional, patent-pending add-on modules to enhance all aspects of 340B operations in challenging and unique environments. • Rapid implementation for both split billing and contract pharmacy solutions to help covered entities meet challenging timeline needs. • Access to your own unique 340B program test environment — before and after implementation. Test environment runs continually in parallel to your live system. • Easy and exportable reporting functionality including detailed data for manufacturer or HRSA audits. • Transition from one electronic medical record (EMR) to another without downtime (contingent upon receipt of dispense file from the covered entity). • Multiple wholesaler support with controlled substances ordering system (CSOS) — efficiently place orders with both EDI (electronic data interchange) and non-EDI vendors. • Two-week sprint release cycles ensure timely software updates driven by customer feedback, regulatory changes, and user needs. • F lexible and “winners only” contract pharmacy pricing models. No true-ups. • Verity Care Card Program — directly pass 340B savings to uninsured and underinsured patients. • Referral capture opt-in functionality to compliantly add meaningful savings lift to your 340B program. • Responsive customer service provided by our in-house staff. • 80% of our customer support cases resolved within two hours. 95% resolved within 24 hours.

• Responsive Support: Designated account managers provide focused support, training, audit readiness, and regular business reviews to maximize your 340B program success and help you maintain compliance. WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 33

Meeting 797> Requirements Requirements Meeting Your Your USP USP<<797> Veltek Simple Veltek Makes Makes Itit Simple

C CLEANING LEANINGAND AND DISINFECTING ISINFECTINGPP RODUCTS D RODUCTS

EENVIRONMENTAL NVIRONMENTAL MONITORING ONITORING M QUIPMENT EEQUIPMENT

GOWNING OWNING G

USP 800 Gown

Cleanroom Garments

VAI every aspect necessary for full compliance including: VAIcovers covers every aspect necessary for full compliance

including:

Consultation on maintaining aseptic processes onsetting settingupupand and maintaining aseptic processes • ■Consultation – our easy to use disinfectants in pre-measured containers RTU containers ■ SimpleMix • SimpleMix® – Veltek’s easy to use disinfectants in pre-measured Easy2Gownsterile sterile garment garment system system • ■■Easy2Gown Easy to use portable SMA air samplers to use SMA MicroPortable® ICS - Veltek’s Viable Cleanroom Air Monitoring device • ■Easy RTU Sterile & Non-Sterile cleaners & disinfectants available in a large assortment cleaners & disinfectants available in a large assortment of packaging sizes • Sterile of packaging sizes ®

SCAN HERE

TO CONTACT US

Veltek Associates, Inc. 15 Lee Boulevard Malvern, PA 19355-1234

With VAI’s innovative product line, Meeting USP<797> requirements is just a phone call away…IT’S THAT SIMPLE!

1-888-4-STERILE H E A LT H C A R E

www.sterile.com @STERILE.COM

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

SMA MicroPortable® ICS From VAI® Offers Superior Precision and Control Combining experience, innovation, performance, GMP manufacturing, GLP testing services, and unrelenting service has propelled VAI as the ultimate innovative leader in the market.

President & CEO: Arthur L. Vellutato, Jr. Founded: 1981

Employees: 200+ Phone:

(610) 644-8335

Address: 15 Lee Boulevard

Malvern, PA 19355

Website: sterile.com

Company Background

For nearly 40 years, Veltek Associates, Inc. (VAI®) has pioneered the design and manufacture of hundreds of cleanroom solutions that surround contamination control. These innovations, many of them landmarks in the industry’s history, allow our customers to overcome challenges, and reach their business goals. Plus, VAI® clients have more than a solutions provider, they have a partner and trusted advisor. With today’s complex research challenges, new competition, and increasing government regulations, a true partnership is more important than ever. For us, it’s simple. Innovation is about listening to industry challenges directly from our customers and not stopping until we find the answer. Together with our clients, we have been developing new solutions for the cleanroom industry for more than 40 years attaining over 150 worldwide patents. Our innovations have allowed our clients to do remarkable things — from biotechnology breakthroughs to pharmaceutical discoveries — that help millions of people every day. From our early days of developing the first sterile garments to our latest innovations, VAI® develops products that revolutionize and simplify aseptic manufacturing.

Product Overview

VAI®’s Environmental Control Monitoring Division (ECMD) addresses the needs of the healthcare, pharmaceutical, biotechnology, semiconductor, and electronics industries with a complete range of facility wide viable environmental monitoring equipment. VAI®’s viable air monitoring equipment is designed to sample a quantifiable amount of air for viable contamination using our patented Sterilizable Microbial Atrium (SMA®) and a standard media plate. Air is directed from the environment to impact onto a media plate contained inside of the Atrium. The media plate is then incubated and tested to determine the number of viable organisms per cubic foot or liter of air.

Additional Product Modules

n SMA MicroPortable® ICS The SMA MicroPortable® ICS provides continuous air monitoring for viable particles at quality control sample points. The SMA MicroPortable® ICS regulates air flow through a SMA Atrium®. A SMA Atrium is a stainless-steel device that directs air from the environment to impact onto a media plate. The media plate is then tested to determine the amount of viable contamination in the environment. It is battery powered and compact, which allows it to be easily moved to desired air sampling points. It combines the sampling capability of the SMA Atrium with calibrated air flow and a touchscreen interface. The SMA MicroPortable® ICS provides strict regulation of air flow and will alarm the operator if the air flow deviates beyond the acceptable range. The system also monitors and indicates a variety of operational parameters including the sample’s volume and elapsed time. It’s a networked device that may be remotely accessed by operators and administrators. The device can export event history to a removable USB flash drive. Event history includes sampling and calibration events. VAI® offers on-site calibration and repair services. Please contact us for details.

Additional Product Lines

VAI ® offers full circle contamination control products and services. • Cleaners, disinfectants, and sporicides (sterile and non-sterile). • Disposable garments: USP<797> and USP<800> compatible options. • Cleanroom ready wipers: low-linting dry and saturated. • Cleanroom documentation: Core2Write®, CleanPrint10®, Core2Print®.

Markets Served

VAI® serves the following markets:

• Hospitals and Health Care Systems • 503A Compounding Facilities • 503B Outsourcing Facilities • Pharmaceutical Manufacturing • Biotech

SMA OneTouch® ICS and SMA OneTouch® Command Systems are used to control calibrated and timed vacuum sequences to connected SMA® Atriums. Both systems allow you to start, stop, and monitor the sample cycle from within a controlled environment while locating the flow center and vacuum pump in a non-controlled environment.

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 35

CAS E S TU DY PIKEVILLE MEDICAL CENTER AND AZINA PARTNER TO CREATE INNOVATIVE PHARMACY CAPABILITIES

Today, PMC employs 3,000 individuals and offers more than 400 services, including every major specialty and most sub-specialties. Technology and innovation, combined with service and vision, are rapidly driving PMC toward its goal of being a national leader in health care. It’s this objective that prompted PMC to partner with Azina (formerly SPARx, the specialty pharmacy division of Comprehensive Pharmacy Services) to improve drug access for patients, innovate all services, enhance patient care, and increase revenue. “We wanted to leverage our existing retail pharmacy to build an innovative specialty pharmacy,” explains Kandi Justice, COO, Pikeville Medical Center. “Our goal was to provide specialty medications to patients quickly and efficiently. This would enable us to greatly improve the patient experience, as well as keep revenue in-house, instead of relying on numerous third-party pharmacies.”

John Petts, PharmD Vice President ~ Azina

36 36

azina.com

CAS E S TU DY

“

We could not have reached this high level of accreditation without Azina’s help and support. Their expertise in this area was invaluable to us.” Kandi Justice COO ~ Pikeville Medical Center

GETTING TO WORK The first step was to conduct a thorough assessment of PMC’s pharmacy operations. “The team examined the medical center’s existing technology, infrastructure, equipment, staffing, workflow, dispensing systems, and customer service frameworks to develop a detailed redesign plan,” explains John Petts, PharmD, Azina vice president. “We had our work cut out for us — especially during a global pandemic. While the pandemic definitely created roadblocks for our team, we were able to navigate these barriers and get started immediately.” The next phase of the project involved working with a team of architects and engineers to design and oversee the construction of a new 7,100-square-foot pharmacy design to include a 1,200 square-foot retail pharmacy and a specialty pharmacy space. The redesign entailed several key pieces, including: • • • • • • • •

A new workflow structure to increase the speed and efficiency of medication pick-up. New refrigeration systems. A stronger, integrated 340B program to increase drug access. Improved staffing. The creation of a private consultation area for patients. Installing software and robotic automation to count and label all drugs. Adding an inventory management system. New, updated software.

Once the redesign of the retail pharmacy was underway, the team began work on building a specialty pharmacy. “As the region’s only specialty pharmacy, we wanted to develop a unique and much-needed service for patients who have rare or complex health problems, including cancer, Crohn’s disease, hepatitis C, HIV, multiple sclerosis, osteoporosis, psoriasis, and rheumatoid arthritis,” explains Lina Abdallah, PMC director of outpatient pharmacy. In addition to focusing on the administration of medications used to treat these complex and rare health conditions, PMC’s new specialty pharmacy also concentrated on the special handling of these medications, such as refrigeration, as well as support with prior authorization, financial assistance, education, adhering to drug regimens, and side effect management. “Our aim was to improve the overall patient experience by connecting chronically ill patients to the care they require. We needed to provide them with specialty medications — including limited distribution drugs from key drug manufacturers — close to where they live and where they receive treatment,” says Abdallah. “Now, they no longer need to wait days, and even weeks, to receive their meds by mail.” The Azina team also worked hand in hand with PMC to achieve dual accreditation — URAC and ACHC. This dual accreditation is extremely important for PMC’s specialty pharmacy.

azina.com 37

CAS E S TU DY “While achieving these accreditations can typically take up to three years, we were able to receive this high standard of care in just 11 months with Azina’s guidance,” explains Abdallah. “This accreditation is crucial because it establishes PMC as a qualified care provider for all of our patients.” Adds Justice, “We could not have reached this high level of accreditation without Azina’s help and support. Their expertise in this area was invaluable to us.”

ACHIEVING SUCCESS Since the beginning of PMC’s pharmacy improvement project, the medical center has experienced impressive results, becoming a national model for innovation. PMC has been able to achieve a time to fill of 2.26 days which is well below the industry average. Furthermore, PMC’s patient satisfaction rates, which were targeted at 80%, achieved a whopping 96%. Call abandonment rates, which were targeted at 5% or less, came in at 2.2%. And average hospital revenue and gross margin numbers increased significantly. The partnership between PMC and Azina exemplifies a very successful collaboration — even during a global pandemic. “We set out to improve patient care and increase revenue for the hospital, but we achieved so much more,” explains Justice. “Azina’s expertise, guidance, support, skills, and turnkey solutions have been absolutely critical to our success. We have accomplished so much.” She adds, “Complex diseases often bring many complications for patients, so our job is making life easier for them. It comes down to being there when patients need us most. And we are now able to do just that.”

azina.com

Develop and drive

high performance outpatient programs to keep your patients on one care continuum The Azina team provides expertise in specialty pharmacy services, empowering healthcare organizations to own their own specialty pharmacy and associated revenue stream.

Financial Opportunity Analysis

Dual Accreditation

Pharmacy Operations

LDD and Payor Access

Everything from A to Z in Your Approach 800-968-6962 | azina.com

FUNCTIONALITY YOU NEED. SERVICE YOU TRUST. POINT-OF-SALE MADE CRAZY EASY.

Innovative Training

Customized Software

Turn-Key Hardware

24/7 U.S. Based Customer Support

WITH RMS, YOU CAN... Make informed business decisions using robust reporting Centralize and streamline pharmacy operations Integrate with your choice of pharmacy management systems

Email us at sales@rm-solutions.com, or give us a call at 877-767-1060.

Implement programs like meds-to-beds and will-call

Scan this QR code to learn more about RMS

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Point-of-Sale to Support Your Outpatient Pharmacy Operations — Retail Management Solutions Improve patient outcomes, streamline pharmacy management, and meet pharmacy goals with a point-of-sale solution tailored for your organization and integrated to your choice of over 30 pharmacy management systems.

President & CEO: Brad Jones Founded: 1998 Toll-Free Phone:

(877) 767-1060 (360) 438-8276 Fax: (360) 438-8284 Address: 4535 Lacey Boulevard SE Lacey, WA 98503 Website: www.rm-solutions.com Phone:

Company Background

Founded in 1998, with a mission to help pharmacies understand and use technology-based tools to run a successful business, Retail Management Solutions continues to lead point-of-sale innovation. Giving pharmacies access to tools and technology to improve patient outcomes, streamline operations, and improve profits. RMS’ POS systems are created exclusively for pharmacies. We listen to our customers, partners, and industry requirements to provide timely, point-ofsale based solutions to solve the challenges faced by pharmacies today.

Product Overview

RMS offers a range of point-of-sale products that are both flexible and scalable to meet the needs of any pharmacy. While our easy-touse till application is at the forefront of day-to-day activities, running a successful pharmacy goes far beyond collecting a payment. There are many ways in which an RMS system can help. n At the Register: RMS customers have freedom to choose from over 30 pharmacy system partners, all with integrations that make prescription sales fast, easy, and accurate. Signatures for HIPAA, safety caps, prescription acknowledgment, etc. are captured at the time of sale and are always easily accessible when needed for reporting and audits. Built-in date of birth verification processes and additional prescription for pickup notifications bring added patient safety and convenience to every transaction. Additionally, every RMS system includes built-in will-call management. Batch multiple prescriptions together into a single bag. Store according to your organizational preferences. Scan a single barcode at checkout. This easy-to-use option improves patient safety and saves time. Beyond prescription sales, OTC product sales are as simple as scanning the item barcode. Custom items can also be created for easy sale of unique products, gift items, etc. Payroll deduct can be added to any implementation for easy employee sales.

Sales can be processed in many different ways to meet the unique needs of your pharmacy. Whether you need standard retail lanes, Meds-to-Beds technology, an option for drive-thru payments and signatures, curbside pickup solutions, or an easy way to track deliveries. You can mix and match to create the perfect technology scheme. n Improving Patient Outcomes: Improving patient outcomes and increasing customer satisfaction are goals at the heart of most organizations today. Nutrient Depletion notifications at the register help you to improve patient wellness by making supplement recommendations based on prescription induced nutrient depletion. Meds-to-Beds technology and support help you to align your pharmacy with organizational goals. Point of sale tailored for bedside interactions and full transaction processing help you work towards increasing patient compliance and reducing readmittance rates as a result. n Easy Compliance: RMS credit card processing capabilities include options for validated P2PE, allowing the potential for reduced PCI scope. Processing integrations also include options for EMV, tokenization, NFC, and FSA/HSA card acceptance. Every RMS system includes optional integration with NPLEx for Pseudoephedrine tracking as well as signatures, ID capture, and tracking for HIPAA, safety caps, prescription acknowledgment, etc. n Headquarters and Management: Point-of-sale applications extend beyond the customer interaction to help you run your pharmacies more efficiently. Enterprise-level multi-location management unlocks powerful tools for policy, pricing, employee, and customer management. Data fed back to the headquarters saves time and resources. For pharmacies managing retail departments, RMS’ inventory management solutions open the door for advanced management of front-end product with wholesaler interfaces, automated purchasing and receiving, price updates, and integrated signs and labels. A host of reports, both canned and customizable, are available. From cash management and employee performance to A/R balances, and more. RMS systems give you the data you need to drive important decisions and run pharmacies efficiently. n When You Need Support: All customers have access to the RMS support line, staffed by our in-house team of U.S.-based technical specialists, 24 hours a day, seven days a week. The RMS customer center is available at any time to request support, access the customer knowledgebase, and more.

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 41

Integrated Temperature Monitoring with i.C3® Information System

Continuous monitoring supports safe storage of vaccines and medications

Intelligent diagnostic information and data in one secure location Monitor and optimize performance with a finger stroke Constant monitoring ensures uniform temperature Available on i.Series medicalgrade refrigerators, -30 freezers, and ultra-low freezers

Learn More helmerinc.com/ic3videos

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Integrated Temperature Monitoring to Support Safe Storage of Vaccines and Medications With Helmer Scientific Continuous monitoring offers safety and security of stored product.

President & CEO: Bruce King

Vice President of Sales & Marketing: Lori Gabrek Founded: 1977 Employees: 300 Toll-Free Phone:

(800) 743-5637 Phone: (317) 773-9073 Address: 14400 Bergen Boulevard, Noblesville, IN 46060 Website: www.helmerinc.com

Company Background

Helmer Scientific is a manufacturer and worldwide distributor of medicalgrade cold storage and laboratory processing equipment. We have over 40 years of experience in providing high-quality temperature-controlled environments, with our products used in over 130 countries throughout the world. We serve customers from our US-based headquarters, which also houses our R&D center and advanced FDA GMP manufacturing operation. Helmer is an industry leader for pharmacy and vaccine cold storage solutions.

Product Overview

i.Series® takes Helmer’s GX Solutions medical-grade refrigeration to the next level. Featured on i.Series® temperature-controlled storage products, the i.C3® Information Center provides intelligent diagnostic information and temperature data, while providing security features to keep the information safe. It consolidates everything you need to know about the status of your storage device in one secure location. With the i.C3®, you can monitor and optimize performance with just a finger stroke. Want to know who’s been opening the door? Simple, check the Access Control Log. With intuitive prompts and messages, it’s never been easier to set parameters, track performance, and download storage data. The i.C3® Information Center is integrated into i.Series® medical-grade refrigerators and -30°C freezers, as well as ultra-low freezers. Whether you’re storing vaccines or medications, it’s critical to have constant monitoring to ensure uniform temperature throughout the space — safeguarding the integrity of the stored items. The i.C3 Information Center enables users to conveniently monitor unit performance, address alarms and alerts, and view and download historical temperature data. The i.C3® Information Center can also help facilities and vaccine providers meet CDC guidelines for vaccine storage and Vaccines for Children (VFC) requirements.

Features & Options

n System Status Console: Monitor the status of the unit with one quick glance at the touch screen home screen, including: current temperature

and alarm conditions; minimum and maximum temperatures; unacknowledged alarms; and historical temperature data. n Interactive Temperature Graph: When you need more information, the interactive temperature graph provides a visual history of performance with shortcuts to the Event Log for more detailed information including: • The One Touch Quick Info feature, which enables users to touch graph for point-in-time detail. • A zoom feature, which provides a close-up of a selected time period. • Jump forward and back buttons can access two months of data. n Event Log and Detail Screen With Event Acknowledgement: The 100 most recent events can be viewed on the Event Log screen. Simply touching an event enables users to drill down to specific information on the Event Log Detail screen, including: • Alarm type. • Start and end date/time of alarm. • Monitoring and compressor probe maximum and minimum temperatures during the event. • i.ACT™ Event Acknowledgement function captures corrective action with signature, date, and time-stamp. n Min/Max Display and Reset: This display shows the highest and lowest temperature occurrence right on the home screen. This function is especially helpful for vaccine storage applications. n Data Transfer Center: Data is simply downloaded via the USB port in the side of the i.C3® Information Center. Extended downloading capabilities and formats offer: • Up to three months of graphs and log data via PDF reports. • 10 years of log data via CSV reports. • One-day and seven-day alarm event data providing detailed log information for each event. • One-day and seven-day graphs for primary monitoring probe temperature readings. n Automatic Alarm Testing: Peltier-based technology utilizes self-test probes that warm or cool to accurately test temperature alarms without affecting the temperature inside the cabinet. n Guardian Plus™ Protection: Protect settings and limit access to keep products secure. Guardian Plus™ includes password protected set points to ensure that proper temperatures are maintained. In addition, Integrated Access Control (optional for refrigerators and -30°C freezers) restricts access to the cabinet with an electromagnetic lock controlled by PIN entry. • Access Control keypad can be set as an alternative home screen. • Access Control log provides an audit trail of door entries and includes the user ID, date, time, duration, and method of entry. • Key override. WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 43

T H O U G H T L E A D E R Video Series

THOUGHT LEADER VIDEO SERIES

Azina Join Michael Heinrichs, Senior Vice President of Business Development, Keith Cook, President, Doug Massey, Senior Vice President of Operations, and Eugene Queener, Vice President of Ambulatory & Infusion, as they discuss a specialty and ambulatory pharmacy solution designed to unleash the powerful potential inside hospitals and health systems.

THOUGHT LEADER VIDEO SERIES

Accreditation Commission for Health Care (ACHC) Join Josè Domingos, Matt Hughes, Renee White, Ralph McBride, Jon Pritchett, Megan Reed, and Greg Stowell as they discuss Accreditation Commission for Health Care (ACHC), for providers, by providers.

www.achc.org

www.azina.com

rxinsider.com/videosTLS.php

THOUGHT LEADER VIDEO SERIES

Mission Critical Delivery Solutions: When Failure is Not an Option Join Kyle Janssen, President & Owner of Community Pharmacy, Mackenzie Farr, Chief Operating Officer & Pharmacist at Community Pharmacy, Ted Johanson, President & CEO, Mission Critical Delivery Solutions, Inc., and John Fiene, Medical Courier, Mission Critical Delivery Solutions, Inc., as they discuss Mission Critical Delivery Solutions: “When failure is not an option.”

www.MissionCriticalDelivery.com

rxinsider.com/videosTLS.php 44

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N

rxinsider.com/videosTLS.php

THOUGHT LEADER VIDEO SERIES

Micro Merchant Systems Join Brian J. Courtney, Pharm.D., Chief Revenue Officer, Ketan Mehta, CEO, Samir Haleem, Director of IT, Sheila Dawalt, National Sales Manager, Heba Macksoud, Pharmacy Owner, and Boris Niyazov, Pharmacist, as they discuss Micro Merchant Systems, PrimeRx™ Pharmacy Management System in a 12-part video series.

www.micromerchantsystems.com

rxinsider.com/videosTLS.php

THOUGHT LEADER VIDEO SERIES

Advancing the Business of Pharmacy

Sentry Data Systems | Expect More

Join Kristin Fox-Smith, MPA, Tammy Zukowski, MBA, and Jim Jorgenson, MS, RPh, FASHP, CEO, as they discuss Advancing the Business of Pharmacy in a 12-part video series.

Join Lidia Rodriguez-Hupp, Joel Hennenfent, PharmD, MBA, BCPS, FASHP, Lisa Scholz, PharmD, MBA, Kenosha Chastang, JD, PRS, MBA, Lateef Durosinmi, and Bill Sander, PharmD, as they discuss Sentry Data Systems.

www.visanteinc.com

www.sentryds.com

rxinsider.com/videosTLS.php

THOUGHT LEADER VIDEO SERIES

CPS TELEpharmacy Join Savannah Meier, Vice President of Business, Paresh Patel, Division President of Telepharmacy, Karen Alesch, Director of Pharmacy Operations, Bhavesh Patel, Director of Pharmacy Operations, Bob Phillips, Human Resources, and Aalap Modi, Director of Clinical Care Services as they discuss CPS TELEpharmacy solutions.

T H O U G H T L E A D E R Video Series

THOUGHT LEADER VIDEO SERIES

The Compliance Team Join Caitlin Warner, Provider Relations, Jack Haire, Director of DMEPOS & Pharmacy Services, Sandy Canally, RN, Founder & CEO, Steve Simmerman, COO, and Scott Muscarella, Vice President of Marketing, as they discuss Exemplary Provider Accreditation in a 12-part video series.

www.cpspharm.com/cps-telepharmacy

www.thecomplianceteam.org

rxinsider.com/videosTLS.php

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 45

COMPOUNDING HEALTH™ www.leiters.com | 800.292.6772

ON-Q* is a registered trademark of Avanos Medical, Inc., or its affiliates. Avastin® is a registered trademark of Genentech, Inc.

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Leiters. We Are Compounding Health™ Leiters is a trusted FDA-registered 503B outsourcing provider of compounded sterile preparations committed to providing healthcare professionals and their patients with the highest-quality medications.

President & CEO: Robin Smith Hoke Founded: 1926 Employees: 215 Toll-Free Phone:

(800) 292-6772 (720) 697-5140 Fax: (408) 288-8252 Address: 13796 Compark Boulevard, Englewood, CO Website: leiters.com Phone:

Company Background

Leiters, founded in 1926, is an FDA-registered 503B outsourcing provider of high-quality compounded sterile preparations and pharmacy services. Leiters has a long history of evolving and innovating to meet the latest regulatory requirements and market needs. All sterile preparations are produced under Section 503B of the FD&C Act (503B Guidance), follow Current Good Manufacturing Practices (cGMP) and USP <797>. The Leiters facility consistently upholds all standards based on the audits conducted by the FDA, States of California and Florida Boards of Pharmacy, multiple health systems, group purchasing organizations, and other independent accreditation organizations. The Leiters team of experts in sterile pharmaceutical manufacturing, repackaging, and compounding provide a sophisticated understanding of what it takes to elevate the quality and consistency of supply in pharmaceutical outsourcing. Leiters combines a highly experienced team, with robust processes, in a new state-of-the-art outsourcing facility to ensure delivery of the highest quality products and services.

Product Overview

Leiters provides ready-to-use compounded sterile preparations and pharmacy services across the continuum of healthcare, including hospitals, surgery centers, physician offices, and clinics. n Hospital Products • Prefilled operating room syringes and I.V. bags. • PCA (patient-controlled analgesia) prefilled syringes. • Surgical Pain Services portfolio including opioid free medications. n Ophthalmology Products • Prefilled syringes, vials, and dropper bottles including: injections, antibiotics, dilating agents, and topical anesthetics. • FDA-Compliant† Repackaged Avastin® Service. n ON-Q* Pump Fill Service • Pharmacy fill service for the Avanos Medical opioid sparing ON-Q* Pain Relief System. • Prefill pump services offered for both Bupivacaine HCl and Ropivacaine HCl.

Additional Information

We combine our team, robust processes, and state-of-the-art outsourcing facility to ensure the highest-quality medications for healthcare professionals and their patients. Through three key pillars, people, place, and product, we are elevating the standards in pharmaceutical outsourcing.

Key Business Partners

Leiters is partnered with many market leading innovative healthcare companies that compliment what we do. The products and services offered by these companies may provide additional value to your organization. Our business partners include: Avanos Medical, Besse Medical, Cardinal Health OptiFreight®, CPS Solutions, LLC, Eye Connect International, Hibernation Therapeutics, Kit Check, and Prodigy Health.

Trade Shows/Meetings Attended

Leiters supports and attends a variety of regional and national industry trade shows and conferences. Please visit leiters.com to view a list of 2021-2022 events we’ll be attending.

GPO Affiliations

Leiters provides its products and services to many leading health systems, community hospitals, clinics, and physician offices. In addition, we currently have national contracts with: HealthTrust, Intalere, JDJ Consulting, Kaiser, Premier, The Resource Group, US Retina, and Vizient. Please contact us for additional information regarding our contracts.

Ordering Information

Leiters offers four convenient ways to place your order. 1. Phone: (800) 292-6772 2. Fax: (408) 288-8252 3. Email: orders@leiters.com 4. Visit the Leiters Online Ordering Portal: orders.leiters.com

Site Visits

We don’t want to simply tell you about what we do, we want to show you! We invite you to visit our facility to better understand the cGMP regulations, sterile manufacturing processes, and automation we use to elevate the quality of our products and services. Come join the growing list of organizations who have visited our facilities. To schedule a site visit or learn more about how Leiters is Compounding Health™, please visit leiters.com. COMPOUNDING HEALTH™ is a registered trademark of Leiters. Avastin® is a registered trademark of Genentech, Inc. ON-Q* is a registered trademark of Avanos Medical, Inc., or its affiliates. 1BUD is from date compounded. † Mixing, Diluting, or Repackaging Biological Products Outside the Scope of an Approved Biologics License Application Guidance for Industry https://www.fda.gov/downloads/drugs/guidances/ucm434176.pdf

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 47

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Capital Inventory, Inc. — Accurate and Dependable Pharmacy Inventory Services

Founder:

William Straub Sr. President: Shannon McArthur Founded: 1979 Employees: 75 Toll-Free Phone: (800) 345-0849 Phone: (770) 928-7202 Fax: (770) 928-2287 Address: 9725 Main Street Woodstock, GA 30188 Website: www.capitalinventory.com

Company Background

William Straub Sr. founded Capital Inventory, Inc. during the late 1970s in Alexandria, VA. The company relocated to Georgia in the early 1980s and now serves the entire nation, including Alaska, Guam, Hawaii, Puerto Rico, and the U.S. Virgin Islands from its office in the Atlanta, GA area. Capital Inventory, Inc. has been in business for over 42 years, providing service to thousands of hospitals, university medical centers, regional medical centers, and health systems. Capital Inventory exclusively services hospital, outpatient, specialty, and infusion pharmacies. Our inventory experts are in pharmacies daily and year-round. Employees of Capital Inventory are employed full-time and receive complete benefit packages. Employees undergo extensive and continuing education including pharmacy practices, drug information, and HIPAA regulations. You can be confident and secure as all of Capital Inventory’s employees undergo an extensive background check including felony, misdemeanor, and sex offender. Our employees are 12-panel drug tested regularly and at a minimum of twice a year. All testing is conducted by third-party specialty companies. Additionally, employees are required to be current with all vaccinations including yearly Influenza and TB testing.

Product Overview

Our people are the difference. Our teams speak “NDC fluently” and understand the dynamics of pharmacy operations. The physical inventory process is seamless and unobtrusive as team leaders strategically place the team in locations throughout the pharmacy to ensure accuracy and efficiency. Before completion of an inventory service, our teams actively work with finance and/or independent auditors while on-site to validate the accuracy of the inventory data collected. Beyond the physical inventory, the data is then received, analyzed, and formatted into a report that includes all pertinent information to allow for accurate and precise analysis of the inventory data. Let our team of experts provide your next inventory valuation with precision, accuracy, and confidence.

n What to Expect on Inventory Day Upon arrival, the Capital Inventory team will be introduced to the pharmacy and staff. Our team leader and a pharmacy representative will map the pharmacy and its respective areas. Team members are then assigned to the designated areas and proceed entering each NDC number and QTY into our proprietary hand-held data gathering computer. Once all areas are completed, the raw inventory data is then transmitted to an independent team for review and analysis. n What to Expect Post Inventory Day Items will be priced according to GPO/Wholesaler Cost Data and Direct Purchase/Secondary Wholesaler Cost Data. Upon review the data will be adjusted, compiled, and valuated. Finally, the inventory data will be delivered electronically as an Excel file. n What to Expect After Receipt of Inventory Data If it is identified that adjustments are needed, we have an easy stepby-step way to apply the indicated changes. When submitted, the adjustments can be made and returned within 24-48 hours. Unlike other companies that do not allow adjustment to the inventory data, we will adjust the data as requested to ensure the final value is a true representation of the on-hand inventory.

Features

n Why outsource your inventory service? • Inventories average three to five hours with our team of experts. • Our teams conduct pharmacy inventories daily. • Minimal interruption for the pharmacy staff and operation. • Teams work seamlessly to ensure that the “snapshot” is a true representation of the inventory. • Eliminating the need for overtime and/or coordination of staffing to accommodate. • Expert valuation and price application of the inventory by an independent party. • Competent inventory specialists accustomed to working with finance and/or external auditors for validation. • A collaboration with pharmacy to provide accurate reporting in a timely manner.

GPO Affiliations

Premier; The Resource Group; Health Trust

More Information

To learn more about Capital Inventory and how we can help you with our inventory services, please contact us at (800) 345-0849 or customerservice@capitalinventory.com. WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 49

CAS E S TU DY ENVIRONMENTAL MONITORING IN COMPOUNDING PHARMACIES: FACTORS TO CONSIDER INTRODUCTION

Jeff Meek Manager of North America Sales, Healthcare Division/ Central Region Manage ~ Veltek Associates, Inc.

WHAT IS ENVIRONMENTAL MONITORING AND WHY IS IT IMPORTANT?

SOURCES OF CONTAMINATION

sterile.com

CAS E S TU DY It is important to evaluate the risk level associated with the compounding done at a facility using risk assessment tools and use this risk assessment to define the EM sampling frequency.

perform the task should be chosen based on efficacy, safety, compatibility, and ultimate performance for the application intended. Failure to properly execute a sound cleaning and disinfectant program well is in direct correlation to a sound environmental monitoring program. It is for this reason that a well-designed EM program is so very important to be able to identify an inappropriate level of secondary contamination and act before it leads to product contamination.

DIFFERENCES IN REGULATORY GUIDANCE

The differences in regulatory guidance are where debate happens among the contamination control community. USP<797> requires a minimum frequency of six months for viable and total particle air monitoring in ISO 5, 7, and 8 classified areas “in operation” state.2 While USP<1116> calls for daily monitoring of ISO 5 and 7 areas, along with twice weekly monitoring of the ISO 8 area.3 Many State Boards of Pharmacy have created their own Code for Regulations on the subject, but the clear majority also follow the USP<797> compendium guidelines. There is quite a large gap between daily monitoring and monitoring every six months. The facilities that follow USP<797> usually comply with the minimum standard and argue this is acceptable because of their shorter beyond-use dating when compared to cGMP pharmaceutical manufacturing expiration dates. Although this may be true, it is extremely difficult to develop any trending data when sampling once every six months. If the facility did not have any other need for semi-annual monitoring (e.g., new equipment, exceeded action level, suspect contamination) the facility would miss out on two entire seasons on collecting data. Depending on where the facility is located, it could be a lost opportunity to collect EM data for any solid trending analysis. For some compounders, they opine that daily sampling is not feasible, especially when many only engage in low-risk compounding. For all other compounders, the answer lies somewhere in the middle. It is important to evaluate the risk level associated with the compounding done at a facility using risk assessment tools and use this risk assessment to define the EM sampling frequency. Medium and high-risk compounding may justify more environmental monitoring to ensure accurate data is collected and appropriate actions are taken to rectify any contamination risk. If your facility determines sampling more often is an appropriate risk mitigation step, then a best practice would be to do air monitoring monthly along with increased surface sampling. This gives better trending data which can be used to improve your contamination control program.

IN HOUSE OR OUTSOURCE?

Taking ownership of one’s program certainly has its benefits. The clear benefit is that you remain in full control of your own program. From implementation to execution and everything in between you have the necessary equipment to perform your own EM testing on your own time schedule. The real-time data from points you deem appropriate supports your program and helps formulate dynamic procedures based on the testing results achieved. Understandably, there will be some trepidation in bringing the program inhouse. There are EM equipment manufacturers that will provide the necessary equipment and will support your program from implementation and set-up to micro identification and a suggested corrective course of action if needed. By owning the equipment outright, you know the integrity of the equipment put in use inside your classified areas that ultimately produce sterile product for patient care. Consider this, not all third-party EM companies are alike. The non-sterilizable equipment brought into your facility by outside testing firms for EM testing was previously used in other facilities. Not to mention the physical handling, storage, and transport of the unit out in the field. The fact is that much of the available equipment used inside the classified area have internal components exposed to outside air which physically cannot be wiped down with a biocidal agent. In the healthcare setting we work, it is all about risk assessment and eliminating any low hanging fruit related to potential risk which can possibly cause patient harm through compromised or adulterated sterile preparations. The guidelines state that at a minimum, semi-annual viable testing be performed. Some operations may seek additional testing voluntarily or be mandated to perform additional tests involuntarily if micro counts exceed action levels and retesting is required. The cost for these third-party tests adds up very quickly. However, it is common to see a return on investment (ROI) in just one, or two, years’ time when you compare the initial cost outlay for the necessary EM equipment compared with EM outsource testing two to three times per year. Once the facility gets over the initial planning and implementation phase of an environmental monitoring program, it becomes a routine and manageable process. With the help of a competent EM equipment manufacturer, these challenges can be easily overcome to take control of your environmental monitoring program, gather more data, and eliminate the cost of third-party environmental sampling all together.

sterile.com 51

CAS E S TU DY STRATEGIES FOR IMPLEMENTING A SAMPLING PROGRAM

No matter what your goals, choosing the right partner can help you select the correct product for your specific needs.

sterile.com

When developing a sampling plan, it is important to first conduct a risk assessment to determine the sampling frequency and what points pose the greatest risk to your compounded sterile products (CSPs) and thus are most practical to sample. There are many strategies for conducting a risk assessment, here we will talk about two: one for surface sampling and the other for viable and non-viable air monitoring. The first is a touch point risk assessment where during an observation period touch points are observed, documented, and analyzed afterword to determine the frequency the surfaces were touched and if these surfaces have high enough risk to justify surface sampling. The second is a traffic flow risk assessment to determine where viable and non-viable monitoring should take place. The traffic flow risk assessment is done by observing the flow of personnel, materials, waste, and finished product. This flow pattern is analyzed to determine high-risk areas to perform viable and non-viable air monitoring. These can include the areas adjacent to pass-throughs, spaces between or bordering ISO 5 areas, and inside the ISO 5 area.4 Partnering with the right equipment manufacturer can help you with the risk assessment process and work with you to develop a strategy to effectively use their viable and total particle air samplers.

EQUIPMENT FOR IN-HOUSE VIABLE & TOTAL PARTICLES AIR MONITORING

There are many factors when selecting the appropriate equipment for your environmental monitoring program. These can include reporting features, wireless connectivity, battery vs AC powered, the ability of the unit to be disinfected, and cost. Again, the right EM equipment manufacturer should help make the selection process easy due to their inherent knowledge of the available equipment, the necessary guidelines for use, along with practical application and knowledge of aseptic best techniques. No matter what your goals, choosing the right partner can help you select the correct product for your specific needs. The viable EM unit for volumetric air testing most used for hospital pharmacy and 503A compounders is a handheld portable device due to its size and convenience. For classified areas, keep in mind the inherent risk of these units is that they are not sterilizable and disrupt unidirectional airflow. For these reasons, the FDA would not accept handheld units inside an ISO 5 drug manufacturing area. Their position for 503A’s appear far less stringent and do not disallow this practice, provided testing is performed immediately after compounding is finished. From a risk perspective, there are EM equipment available that can draw the necessary vacuum to the atrium “head” that sits outside of the ISO 5 PEC to draw sufficient vacuum. The sterilizable head is the only component that sits inside the PEC so there is no issue of potential cross contamination or disrupted airflow. Handheld units that are considered for the hospital pharmacy and 503A cleanroom industry should be validated for their physical and biological efficiency and provide strict regulation of air flow and alarm the operator if the air flow deviates beyond the acceptable range. The system should monitor and indicate a variety of operational parameters including the samples volume and elapsed time. Ideally, consider a network device that may be remotely accessed by operators and administrators for convenience. These devices can export event history to a removable USB flash drive which captures sampling and calibration events. An alternative to the handheld devices for your viable air monitoring is the utilization of a standalone Control Center. These units designed for isolators are used to control calibrated and timed vacuum sequences to individual or multiple SMA Atriums (sampling points) within an isolator system. In addition, the control center for isolators provides strict regulation for airflow and will visually and audibly alarm if the proper air flow is not maintained. Control centers for isolators assure the non-aspiration or return of possible contaminates from the exterior environment to the isolator by providing connections for a purge pump. Total particle counters for the hospital and 503A marketplace should be chosen for convenience of use and application. The typical configuration is a handheld device with the appropriate flow rate and in compliance with the ISO 21501-4, but they are also available in a table-top or wall mount design. Either way, the device should promote a large touch screen with user friendly software for ease of use. Users should be able to view data including records and reports. Data should also be easily transferred to a facility monitoring system, printer, USB, or compatible software for proper record keeping status. Data may be transferred via ethernet, USB, or wireless RS 485 and RS 232 type ports. Handheld and table-top units can usually be powered by battery or plugged directly into a charger. Wall mount models must be connected to facility power. These units are fast, efficient, and accurate. Again, the right supplier should provide guidance and direction to which unit is best suited for your specific operation. References: 1 Compounding Sterile Preparations. American Society of Health-System Pharmacists, 2017. 2 USP<797> Pharmaceutical Compounding – Sterile Preparations 3 USP<1116> Microbiological Evaluation of Clean Rooms and Other Controlled Environments 4 Gonzalez Ramirez, Karen. Risk-Based Viable and Non-Viable Monitoring Sampling Plan for Microbial Control Program within ISO 7 Cleanroom. 2017 5 Guidance for Industry – Sterile Drug Products Produced by Aseptic Processing – Current Good Manufacturing Practice.

Meeting 797> Requirements Requirements Meeting Your Your USP USP<<797> Veltek Simple Veltek Makes Makes Itit Simple

C CLEANING LEANINGAND AND DISINFECTING ISINFECTINGPP RODUCTS D RODUCTS

EENVIRONMENTAL NVIRONMENTAL MONITORING ONITORING M QUIPMENT EEQUIPMENT

GOWNING OWNING G

USP 800 Gown

Cleanroom Garments

VAI every aspect necessary for full compliance including: VAIcovers covers every aspect necessary for full compliance

including:

SCAN HERE

TO CONTACT US

Veltek Associates, Inc. 15 Lee Boulevard Malvern, PA 19355-1234

With VAI’s innovative product line, Meeting USP<797> requirements is just a phone call away…IT’S THAT SIMPLE!

1-888-4-STERILE H E A LT H C A R E

www.sterile.com @STERILE.COM

THE MOST INNOVATIVE TAMPER-EVIDENT SEALS IN HOSPITAL PHARMACY TODAY NEW ISMP & USP 800 IV Bag Seals

IV Bag Port Seals

• Sterile & Paper Free (USP 797 Compliant). • Maintains a 100% sterile barrier* with 3X greater adhesion. • Helps prevent contamination of drugs and provides added protection to pharmacists. • Will not fall off, even in cold storage conditions (down to -20 degrees centigrade).

Vial Seals

• Patented dual-layer indicates true tamperevidence, with “OPENED” marking. • Cost-effective, allows pharmacy to recycle medication and protects patients from dosing errors.

Tamper-Clear Syringe Seal®

Red Syringe Seal

• Dispensing and application training videos available on our website to help with JCAHO training. • Available in major wholesalers and distributors. *Tested in Nelson Labs, Salt Lake City, UT

Visit our website to learn more: www.steri-tamp.com

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Steri-Tamp® Tamper-Evident Sterile Seals by Allied Pharmacy Products, Inc. The only single-use, tamper-evident seal that both provides and maintains a 100% sterile barrier. National Sales Manager: Alex Meadow Founded: 2010 Phone:

(516) 374-8862

Address: 100 Tec Street, Unit F

Hicksville, NY 11801

Website: www.steri-tamp.com Email: info@steri-tamp.com

Company Background

Allied Pharmacy Products, Inc. was founded in 2010 with the focus on improving the preparation and dispensing of intravenous medication in the hospital pharmacy and compounding settings. Steri-Tamp® was developed by a pharmacist who understood the need for better tamperevidence and sterility in IV preparation. Allied Pharmacy Products, Inc. has always been responsive to pharmacists’ requests, which continues to contribute to expanding our product line.

Product Overview

The Steri-Tamp® sterile product line is comprised of seven innovative tamper-evident seals. Steri-Tamp IV Bag Port Seals are available in blue, red, and CHEMO (yellow). The vial seals are available in 13 mm (red), 20 mm (silver), and 28 mm (blue). Steri-Tamp Belly Button Bag Seals (green) are the only seals that will adhere to the port of a Hospira/ICU Medical “belly button” bag, as well as the top of a 13 mm vial. Steri-Tamp's recently released USP 800 and ISMP specific IV Bag Port Seals help address labeling recommendations for paralytic agents or hazardous drugs in a single workflow. Unlike other seals on the market, Steri-Tamp seals provide true tamperevidence. Using dual-layer technology, the seals help to alert hospital staff if a bag or vial has been used or modified. If the top foil layer is removed, the “opened” layer is revealed and the top layer cannot be reapplied. Due to the 3X stronger adhesive, Steri-Tamp is able to provide a 100% sterile barrier.

• Protects the point of entry of IV admixture bags from contamination and accidental double dosing. • Using a simple “twist” method, the seal adheres to itself and the port ensuring no air channels. • The green Belly Button Bag Seal is the only seal specifically designed to cover the “belly button” port, which is located in the middle of the Hospira bag. The seal can also be used on a 13 mm vial top. n Steri-Tamp® Vial Seals • Designed to lay flat on the vial top preventing bacteria from entering the vial. The seal should not overlap the edges. • Helps to maintain the integrity of the medication. • Sized specifically to fit 28 mm, 20 mm, and 13 mm vial tops. A seal should only be applied to its corresponding vial size. n Steri-Tamp® Syringe Seals • Non-sterile solutions to provide tamper-evidence for syringes and other medical containers. • The new Tamper-Clear Syringe Seal® provides clear visibility to the barrel of the syringe and allows barcodes to be scanned. Perfect for sealing small oral, pediatric, and NICU syringes. n Available in 1,000 Seals Per Roll n All Seals Help to Reduce Waste, Improve Workflow, and Save You Time and Money

Testimonials

“ T hese seals have improved our workflow drastically.”

— Pharmacy Technician, LA

“ Love Tamper-Clear and dual layer nature of seals … really loved that they don't fall off in fridge.”

— Pharmacy Buyer, MI

“ We love the Tamper-Clear Syringe Seals — they don’t obscure any information.”

Steri-Tamp also offers two non-sterile syringe seals. Their increased tensile strength allows you to remove easily from the liner and manipulate over any desired container (syringes, pill bottles, inhalers, EpiPens, insulin pens, medication boxes, etc.) without the seal breaking before it is applied. Our new Tamper-Clear Syringe Seal® will now allow you to see through to the markings on the syringe and scan the barcodes on syringes, inhalers, insulin pens, etc.

Trade Shows/Meetings Attended

Features

Ordering Information

n Steri-Tamp® IV Bag Port Seals • Offers the most fool-proof, potentially life-saving way of clarifying whether or not medication has been dispensed.

— Pharmacy Inventory Supervisor, OK

ASHP Midyear, EAHP, CPC (United Kingdom), Annual Compounding Pharmacy Compliance, and various ASHP state affiliate pharmacy conferences. Available through major wholesalers and distributors. Visit our website, www.steri-tamp.com, for order information or to watch dispensing and application training videos. WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 55

Unit dose oral solids McKesson #

Morris & Dickson #

Product description

Strength

UD size

NDC 11

3703665

2302917

981878

Budesonide Capsule (Enteric Coated)

3 mg

20 UD

60687-0596-32

4907010

2027480

612515

Calcium Acetate Capsule

667 mg

100 UD

68084-0479-01

10254113

5703590

3790623

981910

Famotidine Tablet

20 mg

100 UD

60687-0595-01

10260469

5740444

2349314

106591

Febuxostat Tablet

40 mg

30 UD

60687-0538-21

10258312

4149654

3274917

956623

Fenofibrate Capsule (Micronized)

200 mg

30 UD

68084-0329-21

10260081

5740352

2346641

104364

Fenofibrate Tablet

48 mg

30 UD

60687-0618-21

10258877

5728696

2334258

040410

Fenofibrate Tablet

145 mg

30 UD

60687-0629-21

10254284

5704143

3901725

982025

Fluphenazine HCl Tablet

5 mg

100 UD

68084-0846-01

10254285

5704150

3901741

982033

Fluphenazine HCl Tablet

10 mg

100 UD

68084-0950-01

10252050

5688189

1584887

921783

Gabapentin Capsule

100 mg

100 UD

60687-0580-01

10252051

5688197

1584903

921791

Gabapentin Capsule

300 mg

100 UD

60687-0591-01

10252014

5688205

1584911

921817

Gabapentin Capsule

400 mg

100 UD

60687-0602-01

10254190

5703012

2302966

981886

Hydrochlorothiazide Tablet

25 mg

100 UD

60687-0593-01

10258311

5724828

2329746

032094

Hydromorphone HCl Tablet (CII)

2 mg

100 UD

60687-0579-01

10258383

5724836

2329761

032110

Hydromorphone HCl Tablet (CII)

4 mg

100 UD

60687-0590-01

10254966

5709282

2303436

045013

Ketorolac Tromethamine Tablet

10 mg

30 UD

60687-0104-21

10261602

5743703

2358067

109579

Lorazepam Tablet

2 mg

100 UD

60687-0649-01

10260085

5736483

2343838

103572

Omeprazole DR Capsule

40 mg

100 UD

60687-0608-01

10258394

4858015

2016327

257253

Potassium Chloride ER Tablet

10 mEq

100 UD

68084-0632-01

10258893

5728688

2333243

039784

Propranolol HCl Tablet

10 mg

100 UD

60687-0587-01

10254155

5703574

3691490

981803

Rifampin Capsule

150 mg

30 UD

60687-0575-21

10254131

5703582

3693793

981845

Rifampin Capsule

300 mg

100 UD

60687-0586-01

10258214

5726450

2329555

035055

Ropinirole Tablet

0.25 mg

100 UD

60687-0577-01

10258196

5726468

2329571

035220

Ropinirole Tablet

1 mg

100 UD

60687-0588-01

10260130

5736178

2343168

102426

Sennosides and Docusate Sodium Tablet

8.6 mg / 50 mg

100 UD

60687-0622-01

10258624

5728233

2333557

039560

Valsartan Tablet

40 mg

30 UD

60687-0612-21

10258623

5728241

2333581

039602

Valsartan Tablet

80 mg

100 UD

60687-0623-01

10258635

5728258

2333649

039594

Valsartan Tablet

160 mg

100 UD

60687-0634-01

10259425

5731617

2338465

114736

Valacyclovir Tablet

500 mg

30 UD

68084-0215-21

AB #

Cardinal Health #

10254220 10124030

Liquid unit dose AB #

Cardinal Health #

McKesson #

Morris & Dickson #

Product description

Cup delivery

Cup strength

10260982

5742325

2354959

108985

Acetaminophen Oral Solution

10.15 mL

325 mg / 10.15 mL

100 ct

60687-0571-56

10260983

5742333

2354967

108993

Acetaminophen Oral Solution

20.30 mL

650mg / 20.30 mL

100 ct

60687-0571-37

10249925

5676135

1574276

914382

Atovaquone Oral Suspension

5 mL

750 mg / 5 mL

42 ct

60687-0534-78

10261209

5743026

2356897

109017

Hydromorphone HCl Oral Solution

5 mL

5 mg / 5 mL

30 ct

60687-0566-86

10258469

5725668

2328805

034397

Midazolam HCL Syrup (CIV)

2.5 mL

5 mg / 2.5 mL

30 ct

60687-0576-10

10258500

5725676

2328821

034371

Midazolam HCL Syrup (CIV)

5 mL

10 mg / 5 mL

30 ct

60687-0576-86

971820

Milk of Magnesia Saline Laxative (Magnesium Hydroxide)

30 mL

2400 mg / 30 mL

100 ct

60687-0429-76

10251651

5699970

Hitting the mark

3579828

AHP unit dose simplifies one of the most complex parts of your job – reliably obtaining ready to dispense medications – in a format that promotes positive outcomes for your patients.

Pack size

NDC 11

800.707.4621 americanhealthpackaging.com AD202110-0093

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

American Health Packaging, Offering A Broad Portfolio Of Barcoded Unit-Dose Products With a responsive line of barcoded unit-dose oral solutions, a growing liquid unitdose offering, as well as individually wrapped inhalants, American Health Packaging continues to deliver on their commitment to supporting pharmacy efficiency.

President:

Bruce Bennett Toll-Free Phone: (800) 707-4621 Address: Columbus, OH 43217 Website: www.americanhealthpackaging.com

Company Background

Located in Columbus, Ohio, American Health Packaging (AHP) is an industry leader in manufacturing serialized, barcoded unit-dose (UD) medications provided for the healthcare marketplace. As a UD manufacturer, AHP’s commercially-available UD products are available to hospital, institutional, and long-term care pharmacies nationwide through partner GPOs and wholesalers. AHP’s reputation for quality is supported by a 30+ year history of broad manufacturing expertise — operating a facility that is registered with the FDA, fully adherent to cGMP guidelines, and licensed by the DEA to package Schedule II-V controlled substances. Synonymous with unit dose, following years of success and leadership in the production of oral solids, AHP expanded their offering in 2017 to include liquid unit-dose cups and inhalants in 2019.

Product Overview

AHP is committed to supporting pharmacy efficiency through a diverse range of both high-utilization and niche treatments. Producing nearly 600 UD oral solid SKUs for the healthcare marketplace, AHP’s broad selection of products are produced with quality components and printed with legible barcodes that facilitate effective execution of BPOC initiatives. Their wide selection of products reduces the gap between what pharmacies are forced to repackage themselves, and what is commercially available on the market — supporting health systems nationwide in their efforts to create efficiencies throughout the chain of care. AHP’s tailored offering of UD oral liquids provide similar efficiency, safety, and cost-savings benefits as their oral-solids products. Product features include right-sized packaging, thoughtful tray design, differentiated labelling, and accurate barcodes. AHP’s unit-dose inhalants provide efficiency and feature individually-wrapped vials and pouches barcoded to the dose level. AHP oral solids, liquids, and inhalants include major therapeutic classes and product groups to meet unique pharmacy needs. They are continuously evolving to meet the changing demands of caregivers and staff to support more effective medication procurement strategies. As facilities nationwide compete to demonstrate they provide the highest quality of care, AHP UD supports caregivers as they strive to promote positive outcomes for patients. Pharmacies simultaneously strive to be cost-effective as they provide necessary resources for caregivers.

Additional Product Modules

AHP UD supports these objectives while providing cost-savings opportunities. Sourcing pre-packaged UD allows pharmacies to obtain adequate supply while mitigating capital expenses, such as those related to repackaging equipment, bulk supply, and labor.

Benefits for Health Systems

n Patient Safety: Ensuring the right medication is given to the right

patient at the right time — and in the right strength — is imperative. Pharmacies can facilitate effective execution of these “rights” by providing caregivers with as many products in a pre-packaged UD format as possible. Removing repackaging tasks from the pharmacy eliminates a potential point of failure during the UD process as medications arrive to pharmacies ready to dispense. n Pharmacy Efficiency: Pharmacies strive to process orders and supply the proper medications to caregivers for their patients as quickly as possible. Adding potentially-complex repackaging steps to the procurement process not only harms the ability of pharmacy to supply caregivers effectively, but also removes clinicians from their core patient care competencies. In addition, pre-packaged UD often allows for products to be sourced more quickly than third-party repackaging can support. n Cost-Savings Opportunity: Health systems that choose to package on-site must consider all direct costs, such as purchasing capital equipment for packaging areas and paying highly-trained clinical professionals to perform, manage, and support non-core work. AHP UD products allow for pharmacies to avoid these costs while also shifting the potential costs associated with packaging errors. The pre-packaged format also prevents additional fees that may result from utilizing thirdparty repackaging services. n Liability Management: Pharmacy repackaging operations can be subject to distractions from a variety of sources. An active pharmacy environment can encourage lapses in concentration and present opportunities for staff error. Since these errors may vary in gravity and place liability on the facility and caregivers, mitigation of risk is key. Unit dose from American Health Packaging can help shift liability burden away from staff.

Hitting the Mark for BCMA, USP <800> Support

Effective execution of BCMA initiatives require medications that scan correctly at the bedside. With a robust oral-solids portfolio — and growing offering of unit-dose liquids — AHP UD provides reliable access to UD treatments. AHP products promote safety towards BPOC and efficiency in pharmacy while freeing up internal resources. AHP UD supports pharmacies as they strive for compliance with USP General Chapter <800> guidelines. As pharmacies craft effective procurement strategies to meet the needs of their facilities, protecting patients and caregivers alike from potential harm while handling hazardous drugs is a priority. AHP's UD portfolio has a number of NIOSH/USP <800> products already packaged for bedside dispensing which supports compliance to USP <800> handling procedures. WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 57

DRUG DIVERSION Q&A

Q&A

John Burke President International Health Facility Diversion Association

Q. Do you think that the incidents of drug diversion within healthcare facilities have fallen off since the advent of the pandemic? Definitely not. Most healthcare facilities diverted personnel from the jobs of monitoring and detecting drug diversion in their facility to address the urgent needs of the COVID problem. This means that whatever was in place, a diversion specialist, and/or a diversion team, etc., has likely been either temporarily eliminated or at the very least diluted. So, with monitoring likely next to non-existent, it allows the diverting employee even more latitude to divert medication. The mere added stress of the COVID pandemic can cause those with the tendency of diverting or prior addictions, the temptation of stealing medications.

Q. Do you think that the mandatory reporting of theft/loss of a controlled substance is being documented to DEA and state authorities? No, I do not. First, as mentioned above I don’t think adequately trained personnel that are familiar with diversion inside healthcare facilities would recognize the signs of diversion and report the incident/s, since many of those people have been reassigned.

Q. What is a drug diversion specialist, and how does he/she operate within the healthcare facility? A diversion specialist is someone whose job is to monitor daily, the administration of controlled substances by the institution’s healthcare employees. This is typically augmented by various software programs that can assist in pinpointing a drug diversion problem within the healthcare facility.

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N

The diversion specialist is also responsible for identifying potential diversion trends, notifying the drug diversion team, if applicable, and conducting the investigation with the assistance of nursing and pharmacy, which includes conducting interviews of drug diverters and anyone who can provide insight into the incident. They are the primary person tasked with resolving discrepancies involving medication administrations.

Q. What is the best background for a person to be a diversion specialist? Typically, most diversion specialists are a nurse, pharmacist, and in some cases a pharmacy technician. I have seen several pharmacy technicians in this role who do an outstanding job.

Q. What exactly is a diversion team and how do they function? A diversion team is very important to the level of addressing the drug diversion problem within a healthcare facility. The team is at the very least made up of pharmacy and nursing personnel. Others such as risk management, legal, or human resources can also be a part of the team, but if a diversion specialist exists, this person is obviously a team member also. The diversion specialist will oftentimes be the one to call the meeting. Diversion team participants need to be able to assemble within a very short time frame and are typically called together when there is an obvious diversion or unresolved medication error. This meeting is designed to notify the team in a timely manner and for the team to discuss the next steps in resolving the potential drug diversion. The diversion team should debrief after each incident of a bona fide diversion to examine the entire incident, critiquing both the good decisions and where improvement is warranted.

Q. Is drug diversion in the operating room a real problem?

Healthcare facilities need to make sure that in each incident of a bona fide diversion within their facility, they make sure to test the diverter for blood-borne pathogens. This is oftentimes overlooked, and yet may be very important. Protecting patients that have been in contact with a diverter who has a communicable disease as quickly as possible is crucial.

Absolutely. The diversion of drugs inside healthcare facilities operating rooms has always been commonplace. First, the drugs are some of the most powerful and addicting drugs that exist anywhere, and those who work in the OR are specialists in administering them to patients. Those employees in the OR that have addiction issues are experts in the administering of these dangerous drugs to themselves, most of the time, however overdose deaths do occur.

Q. Why is detecting and reporting drug diversion within a healthcare facility so important? When detected why not just fire the offender and move on? There are many valid and important reasons. As mentioned above, there is little chance of testing the diverter for blood-borne pathogens, thus the inability to protect your own patients. A. Diverters will likely move on to the next facility, endangering the lives of their patients and the welfare of the next institution. B. The diverter themselves, are very unlikely to overcome their addiction without assistance and mandatory discipline. You may very well be attributing to the overdose death of this employee or damage to a patient by doing nothing. C. It can be illegal! Some states, like Ohio, require reporting to law enforcement and the regulatory board involved or you can be prosecuted criminally. D. Failure to report to DEA Diversion can result in serious sanctions on your facility, both monetary and the dispensing of controlled substances, or both. E. Large scale legal action can be taken against your facility for not reporting properly when a significant diversion problem occurs in another facility that could have been avoided if your institution had taken the proper action.

BIOGRAPHY

Pharmacy is key here, as they need to closely monitor the administration of controlled substances in the OR. Ideally, any wastage needs to be returned to the pharmacy where random or for-cause sampling can be done. Employees in the OR need to know this is an option that the pharmacy can invoke at will.

DRUG DIVERSION Q&A

Q. What else should be done when a diverter is identified?

In recent years, some of the most egregious OR diversions have taken place, not by those authorized to administer controlled substances, but those with a valid reason to be in the OR but not authorized to administer drugs of any kind. They were able to access their drugs of choice by diverting medication that was left unattended by a person that was authorized to possess and administer the drug. In those instances, the diverter injected themselves and then refilled the syringe with saline or tap water. Therefore, the authorized healthcare professional was unaware of the tampering and the diversions continued. In these cases, it is essential that all authorized administers of these drugs keep strict control of their medications and not leave them anywhere that others can access. It is possible that some training by looking at the case of David Kwiatkowski might stir awareness as to how important securing their medications can be, and thus avoiding a tragedy at your institution.

John Burke, President, International Health Facility Diversion Association

Mr. Burke has been in law enforcement for almost 50 years, with 32 years with the Cincinnati Police Department, where he formed and commanded the Pharmaceutical Diversion Unit. He has a background in all facets of drug diversion and previously wrote a monthly article in an industry publication on prescription drug abuse for over 15 years. He is the past president of the National Association of Drug Diversion Investigators (NADDI).

He is the owner and president of Pharmaceutical Diversion Education Inc., which provides education, expert witness, and consulting to healthcare facilities and law enforcement. He is also the co-founder of the International Health Facility Diversion Association (IHFDA) and serves as its president.

WINTER 2021

H E A LT H S Y S T E M • I N F U S I O N 59

DRUG DIVERSION Buyer's Guide

DRUG DIVERSION Buyer’s Guide American Health Packaging 2550-A John Glenn Avenue Columbus, OH 43217 (800) 707-4621 americanhealthpackaging.com