Given that IV medication errors are dangerous as well as costly, the adoption of IV workflow management systems can allow pharmacy to detect errors in compounding before the medication reaches the patient, potentially saving lives. These systems provide key safety features such as bar code scanning to double check ingredients, gravimetric analysis to provide real-time verification of product accuracy, and electronic image capture, which can facilitate remote verification of compounded sterile products. Furthermore, improved tracking and documentation can help maintain compliance with compounding regulations.
Despite the safety benefits associated with implementing these systems, according to Pharmacy Purchasing & Products’ 2020 State of Pharmacy Automation survey, to date only one-third of facilities have adopted IV workflow management systems.1 Now more than ever, it is critical for hospitals to implement this technology, as the safety benefits it provides are plentiful and well-documented.
1. IV Workflow. IV Safety Supplement. Pharm Purch Prod. 2020;17(3):12.
IVX Workflow from Omnicell
Omnicell’s IVX Workflow aims to help pharmacy achieve safer, more accurate, and streamlined IV sterile compounding. Supporting best practices, this integrated solution can safely and consistently guide technicians step by step through the IV compounding process. Designed for easy placement within the primary engineering control, the system incorporates integrated bar code scanning, gravimetric or volumetric verification, multi-spectral imaging, photo documentation, and label printing. Combined with Omnicell’s robotic compounding, pharmacy can achieve enhanced safety, improved dose accuracy, reduced costs, and compliance in the IV room.
IVX Workflow is powered by IVX Cloud, a Web-based software platform built to manage all aspects of IV sterile compounding workflow that includes an on-premises installation designed to scale across the hospital or health system. The simple interface provides access to Omnicell’s cloud-based formulary of nearly 4000 line items and drug densities. The cloud software supports the build and customization of detailed compounding recipes, drives order routing and workflow management, and enables access to robust compounding dashboards and analytics. In addition, IVX Cloud provides optional integration with Simplifi 797, providing hospital pharmacies with a comprehensive solution to address safety, quality, and compliance across compounding operations.
DoseEdge Pharmacy Workflow Manager from Baxter
The DoseEdge Pharmacy Workflow Manager from Baxter is an enterprise solution that interfaces with the hospital’s pharmacy information system to automate the process of routing, preparing, inspecting, tracking, and reporting on IV and oral liquid doses. The system enables remote verification, allowing pharmacists to verify compounded doses outside of the cleanroom or hospital facility, and to verify doses at sister facilities.
The DoseEdge system helps pharmacy increase safety from preparation to delivery by intercepting compounding errors before they reach the patient. In addition, it drives efficiency and optimization through automated label sorting and routing to the correct preparation area, and via remote verification of prepared doses. Pharmacists are enabled to redirect doses to use for other patients and track volume remaining for multi-dose vials, reducing waste and increasing savings. The system also assists with regulatory compliance by automating the documentation necessary to meet USP <797> standards.
Diana from ICU Medical
The Diana compounding workflow system combines both automated compounding and IV workflow technologies with wireless pharmacist notification, which allows users to remotely verify each preparation on a handheld tablet display without having to gown up and enter the cleanroom. With its integrated high-definition cameras, the workflow can be visualized for faster, more accurate, high-volume compounding, while closed system components help ensure compliance with USP <800>. Diana can improve the efficiency of ambulatory pump cassette filling by easily and automatically removing the air and transferring the drug, taking the physical stress away from technicians. Designed to accommodate existing workflows, Diana’s compounding module fits in as small as a three-foot hood, so pharmacy can cost-effectively incorporate automation without reconfiguring the cleanroom.
Pyxis IV Prep from BD
BD Pyxis IV Prep is a guided, gravimetrics-based IV workflow management system designed to support pharmacy compounding operations for all preparation types, including hazardous and nonhazardous IVs, sterile preps, and oral syringes. The comprehensive system enables gravimetric and bar code verification to help provide safety and efficiency for compounded preparations, as recommended by ISMP’s 2020/21 Best Practices. The hard stop functionality of the IV workflow management system requires all preparations to be completed with accurate drug, diluent, and dose verifications before leaving the cleanroom. Its inventory management software helps reduce waste and optimize inventory usage, while workflow inefficiencies are minimized with process standardization and remote pharmacy verification. For compliance and reporting, all critical details including actual dose prepared, products used, NDCs, lot numbers, and expiration dates are captured and documented.
The integrated task management software, BD Action Manager for Pyxis IV Prep, supports compliance by scheduling and documenting pharmacy tasks, pursuant to USP and state boards of pharmacy regulations. Its integration with Pyxis IV Prep helps enforce compliance through hard-stop functionality, requiring overdue tasks to be completed prior to compounding. This advancement helps simplify complex task management regulations within a gravimetrics-based IV workflow management system.
PharmacyKeeper from Grifols USA
PharmacyKeeper Verification from Grifols is customizable, Web-based software designed to advance patient safety goals, meet and adjust to regulatory compliance requirements, and maximize pharmacy operation efficiencies. As one of several Web applications within the PharmacyKeeper solution, PharmacyKeeper Verification supports the IV compounding workflow step by step through bar code-based product validation, drug and concentration validation, automatic capture of lot and expiration from GS1 bar codes, customizable workflows, compounding photo documentation, compounding approval alerts, remote review and approvals, customizable labels, and recorded audit logs. The system functions as part of inclusiv, Grifols’ comprehensive IV compounding portfolio of integrated technology, software, and service solutions dedicated to advancing quality and safety in pharmacy operations.
Automated IV Workflow Technology from Eurekam
Eurekam’s automated IV workflow technology, Drugcam, aims to ensure efficient chemotherapy compounding while providing the right drug in the right dose to the right patient. This smart video system automatically monitors the technician during the preparation by using real-time image analysis. The system is based on volumetric analysis with an optical volume recognition to auto-verify syringe draws. Drugcam assists with vial recognition, syringe volume identification, bar code/data matrix reading, video recording, and quality reporting, allowing automatic detection and validation of the key compounding steps, remote verification, and comprehensive traceability with video and PDF report options.
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