I recently had the opportunity to attend the ASHP conference in Las Vegas. For those not familiar with the ASHP (I wasn’t before I attended), it’s the American Society of Health-System Pharmacists. Like most societies and associations, they hold regular meetings where pharmacists come together to learn the latest in what’s happening in pharmacology and in managing a health system pharmacy. I was also impressed by the number of pharmacy residents that were present at the event and how the conference embraced those residents.
Needless to say, as a techguy that’s covered the health IT industry, I was a bit like a fish out of water. While I’d helped do IT support for a small pharmacy as part of my day job, I was definitely far from an expert on pharmacy IT and related topics. However, I came to discover that even though the area is a bit different, there are a lot of principles that are very much in common between Pharmacy IT and the broader health IT in general.
In many ways, attending the event felt similar to how I felt when I started covering hospital IT. I’d been working in ambulatory healthcare for a while and so when I started learning the hospital side of things, much of it felt familiar, but there were definitely important nuances that were quite different. The same was true as I learned about pharmacy IT at ASHP.
Thanks to Omnicell, I got a chance to sit down with Mark Sullivan, Pharm.D, MBA, BCPS, FASHP, Executive Director, Pharmacy Operations at Vanderbilt University Hospital & Clinics. As we started to talk, the parallels between the challenges Mark was facing in his pharmacy were so similar to the IT in hospitals and clinics. Here are a few examples:
One Platform for Tracking – Mark had recently gone through a big replacement project that included 300 devices across a wide variety of locations. What he found in this project was how valuable it was for him to consolidate his pharmacy equipment all onto one platform. The problem with his legacy hardware is that it didn’t provide one specific platform for tracking what was really happening. I’ve heard this so many times across EHR software, secure communication platforms, and other healthcare technology. A consolidated platform is valuable in doing analytics or in addressing things like alert fatigue. Turns out that pharmacy IT has the same challenges when they don’t have one platform to track and monitor what’s happening in their organization.
Benchmarking – Mark shared his efforts to create benchmarks for his pharmacists. Clear benchmarks are valuable to ensuring an efficiently run organization that’s following appropriate care guidelines. We’ve seen the value of this firsthand in the work that Mercy Technology Services is doing with SAP to benchmark clinical behavior. It’s hard to hold people accountable for their work and to improve quality if you don’t have high quality benchmarks.
Staff Hours – Turns out that humans don’t like working overnight generally. Finding ways that technology can take care of the overnight needs of pharmacy was an interesting opportunity that Mark and his team were exploring at Vanderbilt. We see many of these same efforts where AI could replace an on call pharmacist or a telemedicine provider could replace an on call specialist during the overnight hours.
On the other hand, I learned about a number of efforts that seemed pretty specific and unique to pharmacists. One that Mark mentioned was the challenge of repetitive work injuries. Much of what was required of pharmacists is repetitive. One thing he was doing to combat this was having his staff rotate through various positions to help provide some variety in what can be a very monotonous job. No doubt healthcare has plenty of other places where repetitive work injuries can occur. Not the least of these is the various wrist and back issues that are reported by doctors using an EHR. Unfortunately, Mark’s solution of rotating jobs doesn’t really work to solve doctor’s repetitive work injuries.
The other technology that could help solve repetitive work injuries for pharmacists is robots. I’ll admit that the robots were my favorite part of the whole show and were extremely impressive. Omnicell gave me a tour of their booth which was demonstrating the concepts around the autonomous pharmacy.
Most people are probably familiar with their Automated Dispensing Cabinets. They’re well designed and provide easy trackable access to medications. Seeing the demo of the cabinets, you realize all of the nuances that are involved in dispensing medications through these cabinets. Especially for things like a creme or other medication that might need to be applied multiple times and therefore needs to be checked in and out of the cabinet for a specific patient. I was happy to see the integration with the EHR software as well as the biometric fingerprint integration for easy, quick access.
More impressive than these cabinets was Omnicell’s central pharmacy dispensing robot called the XR2. Watching this thing was amazing for anyone who loves robots. The precision it used to be able to fill dispensing cabinets and to pull from storage was awesome. While it’s easy to get lost in the simplicity of a robot doing menial tasks, I could see a story behind each individual element. What kind of suction cups does it use? How does it know where a medication is stored? What kind of scanner is needed? How does it open the drawer? How does it track which bins are empty? How much pressure is needed to make the suction work without damaging the product? How does it handle various medication storage sizes? The engineering that goes into the XR2 is amazing.
While I loved geeking out over the robot, you could see how it would be much more efficient and precise in the work it was doing as compared with a human. Nurses know how annoying it can be to get a dispensing cabinet with the wrong medications. Plus, that’s a huge safety issue if you accidentally stock the wrong medications. Watching the robot doing the menial, repetitive task of filling a dispensing cabinet, it was easy to see how a human could make a mistake doing it. Plus, I don’t know anyone that likes doing that job? The perfect opportunity for a robot to replace the menial work no one likes doing.
While the XR2 was impressive to watch, the Omnicell IV Compounding robot was no doubt an even bigger engineering feat. Rather than telling you how this bot works, check out this great video of the bot in action:
Sterile compounding is a challenging thing and is prone to error. Automating this process was no doubt difficult, but it’s easy to see how a robot can do this much more precise than a human. Plus, it was done in a controlled, sterile environment. What was even more interesting about this robot was shared by Mark Sullivan mentioned above. He shared that his vision for this robot is to replace the after hours pharmacist. The only thing missing is a delivery system that will deliver the drug. That would automate the workflow completely and not require him to staff a pharmacist to do this after hours.
While it was definitely a new experience for me to attend an event like ASHP, it was amazing to see how much of what was happening was similar to what’s happening in other parts of health IT. You won’t be surprised to hear that all of these bots and cabinets are also collecting a lot of data. Omnicell is putting that data to use in their new Omnicell One data analytics product. There’s a lot of money to be saved by using your pharmacy data to give you better visibility into your inventory and to identify drug diversion activity. I did find it interesting that Omnicell was offering not just the analytics, but expert services to help understand what the data means. This is smart since data is one thing, but understanding what the data mean is a new level of value.
All in all, pharmacy IT definitely has unique elements, but the principles of technology adoption and usage applies very similarly. Plus, I think other areas of healthcare could probably benefit from the bots being used by pharmacy. Even if it may be a virtual bot more than a physical bot. Principles of standardizing, automation, and fault tolerance likely still apply and could benefit our use of AI bots across all of healthcare.