Helpful Ideas

Choosing an Automated Packaging System: 10 Key Considerations

Solution: Objective evaluation of the key performance characteristics of competing systems in light of the pharmacy's current and future needs will point the way to the best choice. The use of automated prescription filling and multi-dose compliance packaging systems has become widely accepted for pharmacies that serve patients in a variety of alternative settings, including assisted living and extended care facilities, adult group homes, and outpatient clinics. However, comparative performance data to guide the selection of automated packaging systems is often limited or unavailable, even for the most widely used systems.

In my work as an independent engineering consultant, I recently worked on behalf of a large pharmacy provider to compare the "real-world" performance of two leading systems at their site. My evaluation revealed significent differences between the two systems with regard to several key performance characteristics. For example, with one system file transfer was almost twice as fast, maximizing efficiency and ease of use. Packaging was almost four times faster. I also discovered that one of the systems wastes a good deal more medication and supplies, while requiring considerably more pharmacist and technician labor to operate and maintain. No automated system will be right for every pharmacy, but the following list of 10 key considerations can be helpful in narrowing the field:

1) Speed and throughput
An automated system should be fast so as to provide maximum throughput efficiency. How many packages does a system produce per minute under various dispensing conditions (e.g., single versus multi-dose)? Sixty packages per minute is widely considered the "gold standard" for speed.

2) Capacity
It's essential to pick a system that can handle not only your current needs, but also your projected needs. Look for one that has virtually unlimited formulary capacity and contains a large number of medication dispensing cassettes in the unit itself. Are the cassettes easy to refill quickly? How many medications or medication doses can the system store and process? The system you choose should perform continuous packaging without interruptions to refill numerous auxiliary trays; such delays create significant time and labor inefficiencies.

3) Unique/exception dose capabilities
Can the system automatically and accurately package half tablets, "minimal-use" medications, and other "exception" doses while maintaining the user-requested sequence of medication packages? This is important to maintain continuous, efficient, and error-free operations.

4) Labeling capabilities
Highly flexible packaging and printing capabilities are both key factors in terms of the pharmacy's enhanced patient compliance, reduced medication-pass times, and overall customer satisfaction. Can the system directly print information such as the patient's name, date, room number, administration time, prescription number, prescriber name, barcodes with text and other data, and other desired information? Such capabilities facilitate automated charting, distribution, and quality assurance.

5) Batch processing
It's very important to learn how a system's batch process works. Does it keep the orders as a separate batch or does it "dump" them into the existing orders? This will determine how you will process orders. Dumping can lead to duplicate filling of orders-a very dangerous scenario.

6) Accuracy and quality control
Does the system have a proven track record of accuracy? How often and when is it necessary to check medication packets for accuracy? When are alarms triggered? What features and safeguards does the system offer to minimize the potential for human error?

7) Software interface
An automated packaging system can only be as good as its ability to communicate with other systems. Does the system provide "seamless" integration with your pharmacy's operational software? Make sure that the interface with your computer system is complete and has been tested in your facility.

8) Reporting capabilities
What types of reports can be generated, and how easy are they to produce? Can they be customized to precisely meet the needs of your pharmacy and your customers?

9) Customer training and support
Ask prospective vendors about their customer support history and capabilities, as well as any customer training provided. Do they offer a complete range of consultation services and local service support?

10) Documentation of vendor claims
Ask for several customer references, and be sure to make time to follow up with a call or visit. Carefully ascertain similarities and differences between their operational needs and yours. Ask them to characterize their experiences with the companies you're considering: Would they purchase the same system again? If not, why?

Once each system's performance has been evaluated in light of these criteria and the list of systems still under consideration has been whittled down to two or three, you might want to consider designating a professional team to independently evaluate the final candidates.

When I perform such evaluations, I test the systems on several occasions to determine their relative speed, cost, and effectiveness, as well as user satisfaction levels and other criteria. It's important that the same pharmacy personnel operate both machines, and that trial medication batches packaged by each system are representative of typical batches the pharmacy normally prepares. Performance data should be collected by an independent observer who watches the processing of each batch but does not participate in the operation of the equipment.

Finally, I interview current users of both systems about their experiences, observations, and preferences. Only then am I confident that the system I recommend to a client will represent a move toward increased efficiency and quality control-not a costly mistake.

Richard M. Bilof
Engineering Consultant
Midwest EMI Associates, Inc.
Mundelein, Illinois
847-816-9886