In November 2019, Stanford Health Care, an academic medical center consistently ranked among the best in the U.S., moved into a new hospital building. With seven stories and 824,000 square feet, the hospital required over a decade and two billion dollars to plan and construct. Most descriptions of the hospital focus on the airy private patient rooms or the state-of-the-art operating rooms, but one of the most technologically sophisticated aspects of the building is found in the basement. That’s where the hospital’s pharmacy lies, and it has some of the most advanced robotic equipment for storing, dispensing, and distributing medications found anywhere.
How a Robotic Pharmacy Works
A substantial amount of the pharmacy space in the new building is taken up by three robotic devices, all from the same manufacturer (Swisslog, which is, contrary to expectations, an Italian company). Two are for bulk storage and retrieval of medications. Called BoxPicker, these huge rectangular boxes have stacks of drawers containing boxes of medications. A mechanical picker moves up and down the aisles and removes the boxes that are needed. Many of the medications in these boxes are destined for dispensing cabinets on patient floors. They’re commonly-prescribed drugs that many patients might take. Less frequently-prescribed and bulky medications remain in the BoxPicker. It’s like a pharmacy shelf that brings medications to the technician and records inventory information in real time.
The other machine is a PillPick robot, also made by Swisslog, which packages up a day’s worth of medications for a particular patient into a small bag. There is one pill in each vacuum-sealed bag; it’s extracted from a bulk bottle by suction. if the patient requires multiple pills, the bags are connected with a plastic ring that connects all medications for a patient for a day. The PillPick can package up 1000 doses per hour, which used to require a pharmacy technician 4-5 hours a day to pack manually.
All three robotic machines automatically keep track of their inventory, and automatically generate orders for the hospital’s drug wholesaler each day. They are also all connected to EPIC, the hospital’s electronic medical record (EMR) system. Stanford is the first hospital to integrate the EPIC and Swisslog systems for full management of the medication supply chain. EPIC manages the medication inventory and is the source for all medication orders for patients. If a physician enters a medication order for a patient into EPIC, it’s automatically sent to the Swisslog system and the orders are automatically sent to BoxPicker or PillPick, and then packaged by a technician or automatically. If there’s a need for quick delivery, the pharmacy technicians put them into the hospital’s pneumatic tube delivery system for rapid arrival at the patient floor.
New Roles for Human Pharmacists and Technicians
There are 70 pharmacists and over 100 pharmacy technicians working in the hospital. Their jobs have changed substantially with the new building and systems. Deepak Sisodiya, the Director of Pharmacy at Stanford Health Care, explained:
In the old building and before the new pharmacy management system was installed, pharmacists and techs spent much of their time picking up drugs for patients and delivering them to the bedside. That gave them less time for focusing on quality control and—particularly for the pharmacists—consulting with physicians and patients about their medications. READ MORE
by Tom Davenport
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