As originally asked by John Ashford.

Would automated satellite pharmacies be the way forward for a more efficient system in hospitals? your comments would be welcome.

Jeff Sugarman
SUGARMAN Government Grants Financing Division of at SUGARMAN INTERNATIONAL Group
I am fascinated by the development of these automated pharmacies.I would like more
information on how I could connect with key manufacturing and distribution companies
for North American market.

Frédérique Fremont
Medico Technical Department manager
We purchased the machines. the first one was even imported from the States. Leasing is not well known and a bit complicated in French public hospitals.

John Ashford
Managing Director Smart Tools (UK) Limited
Did you lease or purchase the machines?

Frédérique Fremont
Medico Technical Department manager
I cannot give gou exact figures but it does save nursing time. They do not have to check their stocks, place reorders to the pharmacy and drug dispensation to the patient is much more secure. Real time drug inventory means the pharmacy deliver products on time, nurses do not have to go to the pharmacy to get the missing drugs (such us: Ambien), during week-ends for example a simple phone call to the pharmacy tell them the ward where they can fing a rare or missing drug. This project is part of the work we are doing to take logistical tasks away from the nurses so the can be with their patients. For drugs and some sterile medical devices, the Pyxis replenishment is done by the pharmacy technicians (twice a week or more depending on the ward specialty).
In the operating theater (anesthesia products and some medical devices) we have another type of cabinets where you do not have the prescription, but when you take the products it is put into the Electronic Patient Record, so you have full traceability of what is used during surgery and in the recovery room.

John Ashford
Managing Director Smart Tools (UK) Limited
Hi Frederique did it save the nursing staff valuable times giving improved patient care?

Frédérique Fremont
Medico Technical Department manager
We are using Pyxis automated cabinets in our 650 beds public hospital in France. All the wards are equipped and they are now linked to the IT prescription. The doctor make the prescription at the patient bedside, it is then validated by the pharmacists (mandatory in France), when the nurse prepare the drugs for a patient, she identify herself (fingertip), type the patient name, the prescription appears and the right drawer(s) open. At bedside the nurse validate the administration. The only link we do not have yet to secure the whole process is bedside scanning, which hopefully I hope we will get soon.
We have implement ing the cabinets since 2005 on a period of 5 years and the nurses would not go back. Another interesting point is that we have a full real time view of the hospital inventory and we hope to link it to the WMS we are implementing to have an integrated supply chain including our suppliers.
Concerning the investment, it is important, but we got a decrease in stocks, in emergency demands to the pharmacy. Our head pharmacist was a great mover in that project and we are also helped by French regulations which are very stringent on the drugs prescription and administration process. Reimbursement of high value drugs and medical devices depends on compliance to these regulations, so it helped convince our CEO…

John Ashford
Managing Director Smart Tools (UK) Limited
Hi Jeff there are 3 main players McKesson / Pyxis (cardinal health) / omnicell from what I can see. We originally designed them for the industrial sector we will probably have the most secure system. It will be user friendly a very easily adaptable system with swap in swap out systems and configurations we can have approx 4000 secure compartments in 1sq mtr but our pricing due to new technology will be in some cases half the cost of some of the leading companies the point is to make it affordable to the masses.

Jeff Sugarman
SUGARMAN Government Grants Financing Division of at SUGARMAN INTERNATIONAL Group
This is an interesting area of development.I would like to know more about development
of this satellite automated pharmacy with regard to use and operation in Canada and
other countries.What companies are involved in the manufacture and development-marketing of these products and what is the cost and price strruture? .Please forward me additional information on this exciting new technology.

John Ashford
Managing Director Smart Tools (UK) Limited
Hi Anita what dispensing machines do you currently use?

Anita Wample
VP Regulatory Affairs, Clinical Affairs and Post Market Regulatory Compliance at Siemens Healthineers
One more note, with a central pharmacy dispensing for satellite pharmacies ; there are unique inventory management challenges and the AmerisourceBergen software currently meets these requirements in large health systems.

Anita Wample
VP Regulatory Affairs, Clinical Affairs and Post Market Regulatory Compliance at Siemens Healthineers
There are multiple companies that sell automation for retail and hospital pharmacies, nursing units, ER, OR, or long term / skilled nursing facilities. AmerisourceBergen covers all of these markets and has representatives in the US, CAN, AUS and other locations.

To meet security requirements locked cabinets, single access drawers for unit doses and security permission levels built into the software as well as barcoding of product are some of the functions available. I hope this helps

Donald Forman
Director of Wellness
While I agree with Asher that automated dispensing is the future, pharma does not necessarily address the root of the problem, which could well be malnutrition. At Nusential, we have assembled whole foods and herbs appended to diseases to address the nutritional illiteracy. Just plug in a disease, ailment, or condition, (over 800 are currently listed) and foods, herbs and spices that have been clinically proven to be effective are suggested. So yes automated pharmacies and yes to automating the wellness process.

John Ashford
Managing Director Smart Tools (UK) Limited
Hi Jeff yes they can be available for the Canadian market, currently theres no representation there if you would like to see the range visit inventorycontrolequipment.com but there’s a newer hitech range being released this month it’s going to turn everything on its head.

John

Jeff Sugarman
SUGARMAN Government Grants Financing Division of at SUGARMAN INTERNATIONAL Group
How do these automated pharmacies work.Are they available for use in hospitals
in North America.

John Ashford
Managing Director Smart Tools (UK) Limited
The main issue at the moment is the cost of the machines the base dispenser from Pyxis is approximately $20,000 dollars

Mark Warburton
Managing Director at 4Front Renovations
From a security perspective, bar-coded medication provides security so that incorrect picking of medicines is minimised. Certainly stock management will improve which will impact positively on cost control. This should help to offset the cost of the systems.

Burrell (Bo) Clawson
I research patents & design products to get a patented competitive position: Over 30 patents.
Pyxis was developed starting in the late 80s in Southern California and by the mid 90s sold to Cardinal and is now a part of their split & is in CareFusion.

It was developed to control devices and medications for floor staff so that the item, patient and clinician could all be connected and documentation controlled to keep everything straight in the hospital.

My partner in our device business uses the Pyxis in the Emerg. Dept. everyday and it is a big time and documentation saver.

John Ashford
Managing Director Smart Tools (UK) Limited
Hi the security is paramount in the health sector set security levels as to access of the user once the product and quantity is selected it will only allow access to that compartment it’s easy to use.

Dr. Suresh Saravdekar
Medical Consultant- Freelance, Health Care, Pharmaceutical, Medical devices, IMS BHU and Krishnamurti Foundation Varanasi
Yes it will. But I am not clear about its user- friendliness. And of course the safety?

John Ashford
Managing Director Smart Tools (UK) Limited
Hi thank you for the comments, do you currently work with these systems?

John