New equipment reduces risk to patients
SASIWIMON BOONRUANG
Dr Karoon Mekanontchai, a medical director at Bumrungrad International Hospital, explains the operations of the Pharmacy Robot. |
At Bumrungrad International Hospital the first pharmacy robot in Asia is able to ensure patients 100 per cent safety while dispensing drugs, thanks to an automated drug management system.
With a minimum of human involvement, the pharmacy robot called "PillPick", a system developed by Swisslog, takes pharmaceutical items in bulk and, in a fully automated process, packages, bar-codes and labels them in individual doses.
The unit doses are then automatically placed in storage for future retrieval and dispensing to patients.
Patrick Downing, product unit manager of the Microsoft (Thailand) Health Solutions Group, explained that the pharmacy robot begins working once a doctor types a drug order into the computer system, running a drug-to-drug interaction check.
If two or more drugs being prescribed together might cause a negative reaction or harm the body chemistry, the software will issue a warning and the machine will propose alternative drugs, Downing said.
The robot can manage around 900 different drugs.
Unit dose medications are dispensed by the machine or are automatically loaded into a storage module, called DrugNest, which comprises 500 plastic containers.
The machine is capable of holding 44,000 individual unit doses - a week's supply of medication for around 400 in-patients.
During the day, a nurse, who has a small handheld computer, can check the drug with the patients' chart or wristbands.
The computer guarantees that the right drug goes to the right patient, Downing said.
James Snell, senior program manager of the Microsoft (Thailand) Health Solutions Group, said that administering medication basically involved five "rights".
Administering medication was quite challenging, he said. "There must be the right drug for the right patient at the right time, in the right dose, by the right administrator," said Snell, who is a pharmacist-cum-software developer.
It's all about safety, he said. The system scans the barcode to check again for the five rights.
"Statistically, distributing 44,000 drugs every week a year, you might have an error, but we try to make the small possibility of error close to zero," Downing added.
The preparation and dispensing of medication in hospitals is inherently complex. There can be more than 100 steps from the time a prescription is written, to the time a patient receives the medications.
Citing statistics from the Institute of Medicine in North America, Snell said there were more than 770,000 errors a year, and 20,000 to 30,000 people die in hospital due to receiving the wrong drug at a wrong time.
This is not just due to administrative errors alone, but the whole process, the so-called "medication use process," and not just the prescription of the drug. When a doctor prescribes a drug, it may be inappropriate, or there may be an interaction with other drugs or an allergic response.
The PillPick robotic system minimises any such errors while barcodes help identify a drug.
There is a comprehensive closed-loop medication management system that spans the whole process of prescribing, reviewing orders, supplying and monitoring what beneficial effects a patient would get from a drug, Snell said, noting that it would work with Swisslog's PillPick robotics and Microsoft's medication management system.
Dr Karoon Mekanontchai, a medical director at Bumrungrad International, said the hospital treated more than 1.2 million patients from 190 different countries each year. The Swisslog software would interface with the Microsoft Amalga Hospital Information system which managed clinical workflow, billing, regulatory compliance and medical records.
Downing pointed out that lot of hospitals purchased MRIs or new CT scanners and could charge the patients for the use of this equipment, but that here, a big investment of 58 million baht in this machine was 100 per cent for patient safety. "There's no return on investment and this is definitely the first in the region," he said.
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