By Jennifer Hillman, MBA, PharmD, Director, Inpatient Pharmacy Services, University Health System
Automation has been a part of pharmacy practice for decades. However, complex compounding robotics are less common and under continuous development to meet pharmacy demands. Reasons for lower adoption rates include high cost, product complexity, speed and product limitations. Before considering the purchase of a robot, the pharmacy should have thorough knowledge of product functionality and comfort with outcomes. I’m highlighting these expectations for improved decision-making.
Pharmacy staff working directly with high-level robotics must develop technology skills to be successful. These skills are most often taught during an onsite training session. Training sessions require the pharmacy workforce to be off the line. The more complex the robot, the longer the expected training. For example, when working with complex intravenous sterile compounding robots, the minimum expected training time is 40 hours per person. There is a temptation to reduce or omit training; however, lost training upfront generally leads to additional time and expense post implementation. Therefore, it is essential that pharmacies create time for key staff to be off the line to train on the robot.
In addition, pharmacies should target robotic training to a selected number of staff with an affinity for technology. The benefit of a small number of operators is increased interface time with the robot, which in turn sharpens skills and expands capability. The limitation of a small subset of trained robotic operators is a limited labor pool. Therefore, utilizing an untrained staff member to operate a robot places an expensive piece of equipment in jeopardy of misuse or damage.
Compounding robots are often suggested to reduce personnel labor requirements in pharmacy operations. In reality, the more complex the robot, the more time staff will be required to operate, troubleshoot and manage.
Robotic automation can be sold with the promise of reduced time required to prepare the end product. Depending on the end product, the robot may be faster than the manual process; however, robots require upfront prep time which is not always factored into the equation. Achieving the expected production speed can also take time as staff adapt and learn the capability of the automation. In addition, robots require intricate cleaning time between batches adding to production time. Finally, staff may be somewhat freed up to move on to other tasks when operating automation; however, the robot will require continuous oversight requiring the staff to remain in close proximity.
Supervision and Human touchpoints
Pharmacy robotics require a surprising number of human interaction touch points during the completion of a task. There is a need to feed and change consumables, troubleshoot errors, and intervene when the robot is producing an unexpected outcome. Before purchasing a robot, ensure the company has provided a clear expectation for the number of expected human touch points in a given period of time.
Pharmacy robotics has its own set of challenges, but incorporating this technology into the pharmacy is important for the development of safer and high-quality end products.
Robotics are generally inflexible when it comes to medical consumables such as medications, syringes, caps, diluent tubing, etc. Typically robots are limited to one or two specific consumables. When backorders or shortages occur, robots can become obsolete until the correct parts or calibrations occur to return the machine to operate. To best avoid this scenario, the pharmacy should target procuring and storing a 3 to 6 month supply of all consumables. When a backorder occurs, the pharmacy will have the time to work directly with the robotic company to program the robot with the new consumable, thus ensuring continued operation of the robots.
Unfortunately, not all robots are capable of universally completing all tasks related to an item or a process. In addition, there will be medications that cannot be prepared by the robot. Therefore if robotics are implemented, pharmacies will need to retain standard operating procedures (SOP) for manual processes. Product line limitations should be discussed and measured against the pharmacy’s goal prior to consideration.
Despite the complexities mentioned above, robots are designed with many safeguards to reduce and or eliminate medication errors. Bar code scanning, photography, graviments, and in processes where measurements make automation superior to the manual process. Robots are also able to deliver the same outcome regardless of the size of the batch. With challenges in the labor market, automation can serve as a valuable member of the team, augmenting the labor that is available.
Pharmacy robotics has its own set of challenges, but incorporating this technology into the pharmacy is important for the development of safer and high-quality end products. The key to successful automation integration is to partner with companies who are willing to make frequent and timely modifications based on customer feedback and for end users to challenge the automation for continued improvements.