Wednesday, September 25, 2013

URMC to automate its compounding pharmacy operation

The University of Rochester Medical Center’s pharmacy plans to automate its compounding pharmacy operation, installing five robots and new specialized software to do much of the work now done by human pharmacists and tracked with paper records, URMC officials said Monday.
Compounding pharmacies prepare saline, antibiotic and other solutions for intravenous delivery.
When it goes on line in January, URMC’s automated compounding center would be the largest installation of its type his company has installed, said Gaspar DeViedma, executive vice president of Health Robotics SRL.

Based in Italy, Health Robotics is a global supplier of such systems to hospitals. The largest similar installations it has done are four-robot systems at the Harvard University-affiliated Brigham and Women’s Hospital in Boston and in a Turkish hospital, DeViedma said.

Health Robotics claims to have put in 80 percent of the robotic compounding installations in use worldwide.

Automating the compounding process will reduce the chance of error and contamination in preparing IVs to virtually nil, said URMC pharmacy director Curtis Haas. Robots can tell if a wrong compound has been formulated. And they are programmed to move through the series of steps needed to formulate an IV dose, only after determining each step has been completed correctly.

Reducing human contact with IVs being prepared will cut the chance of contamination to nearly zero, Hass added. And while not all IVs can be prepared by robots, the new Health Robotics software systems will impose the same series of checks on human pharmacists as those employed by the robots.

Haas compared the software-guided IV formulation process to filling out an online form that requires certain information. If a step is left out or an error made, the software will not let the pharmacist move to the next step.

The installation’s total cost is hard to compute immediately, Haas said. The robots cost $1.8 million but workflow software, licensing fees and ongoing maintenance costs add to that. 

Still, Haas believes, the conversion will on balance save URMC money. Using only human pharmacists, he said, the medical center cannot formulate all the IV solutions its hospitals need. With the robotic system, it will be able to boost production sufficiently to supply all its own needs, producing savings that will offset the robotic system’s extra costs. 

Previously little known outside of the hospital industry, compounding pharmacies shot to unwelcome prominence last year, after the Framingham, Mass.-based New England Compounding Center shipped contaminated IV bags to 75 hospitals in 23 states. The contamination caused an outbreak of fungal meningitis that killed 48 patients and infected more than 700 others.

URMC was not among institutions that got contaminated product, Haas said, but like other U.S. hospitals it is dealing with tightening oversight of the compounding pharmacy industry imposed in the wake of the tragedy.

Food and Drug Administration rules always demanded IV solutions be compounded only by prescription. Because compounding pharmacies are not subject to the same rules as drug manufacturers that regulation is meant to discourage mass production of such solutions.
Still, hospitals can order in bulk from compounding pharmacies by citing estimates of future prescriptions they expect their doctors to write.

The FDA stepped up its oversight of compounding pharmacies this year, citing quality problems at 50 outsourcing compounding pharmacies.

An expectation that the regulator will continue to tighten compounding pharmacy rules was another spur to automate URMC’s compounding pharmacy operation, Haas said.

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