Summary Points: You've received approval to buy new technology, so now what?
You've received approval to buy new technology, so now what?
Look at monthly costs as well
Once a health system pharmacy receives approval to buy expensive new technology, such as carousel and packager equipment, it's time to put that money to the most efficient use, an expert says.
"Once I get the approval to spend the money, I put together a formal RFP, and then I sit down with each vendor to very clearly identify my needs and limitations," says Ronald E. Lay, MS, RPh, pharmacy supervisor at the Penn State Milton S. Hershey Medical Center in Hershey, PA.
"The vendors need to understand that they can't try to sell me $750,000 worth of equipment if I only have $400,000," Lay says. "That's a waste of my time."
Also, pharmacy directors and vendors should determine space limitations and interface or integration limitations, he adds.
For instance, a particular piece of equipment might automatically download information from the wholesale ordering system, Lay says.
In another system, this might require a manual step, and so it's not seamless, he adds.
"So the question is whether you want an interface or a seamless transaction," he says.
Another point that often is overlooked is the monthly cost of having the new technology.
"I look at the cost over a five-year period because there are monthly maintenance fees to pay for support," Lay says. "If something breaks down then someone will come and fix it for you."
Those monthly fees can vary widely.
"So if you have a difference of $500 a month over a five-year period, then that's a big difference," Lay explains. "The actual purchase price might be more for one system, but if the support cost is higher then you could end up paying a whole lot more money in the long run."
Other costs to consider are freight charges since the equipment typically is big and heavy, Lay says.
"Are the freight charges included? Is installation included? Or are those separate costs?" he says. "What is your overall price? What will you wind up paying? You need to take all of it into consideration."
Also evaluate proposals for detailed items, such as necessary personal computers, printers, scanners, bins, carts, work tables, and other things that might be needed but are not included in the price, Lay says.
"You don't want surprises, so evaluate everything you might need," he says.
Once a pharmacy director and health system have decided on a particular vendor, then it's time to set up an implementation timeline and meet with the vendor's project leader.
"Give yourself at least six months," Lay says. "This isn't something you want to rush because it's a very complex project."
It's good practice to build in a couple of extra weeks for unexpected delays and obstacles, he suggests.
"Don't assume every single step along the way will work perfectly," Lay says. "If the machinery is supposed to arrive on a certain day, and the roads are icy so it doesn't get there for a day or two, then installation will take longer."
When the Penn State Milton S. Hershey Medical Center installed new carousel technology the project went a week or two later than expected, Lay recalls.
"But it all went very well, and it would have gone poorly if we had tried to rush it," he adds.
Another piece to the implementation process is to determine how the work area will be designed.
Lay recommends asking someone from the health system's facilities department or an architect to help with this process.
"I tried to do it on my own and mismeasured something," Lay says.
It's difficult to anticipate the space needed in the carousel, as well, because some products are bulky and may take up a whole shelf in the carousel, Lay says.
"You have to figure out how much space you need," he adds.
Some organizations will purchase a high-capacity packager so drugs can be purchased in bulk.
"They can be integrated with the carousel and information system," Lay explains. "And instead of drugs coming out of the carousel, they come out of the packager which will package them and put them out."
Each hospital system should analyze how they might benefit from the packager unit and whether they are prepared to buy bulk products, Lay notes.
"We thought we'd buy everything in bulk, and then we switched gears and bought everything in unit dose because that's what worked for us," he says. "When you consider buying a packager, talk to the people who are using them to find out the pros and cons."
One issue is that more drugs now are available in unit doses, so health systems that have packagers might not be using them at full capacity, he adds.
Another important part of implementation involves building the carousel's drug database.
"The building of a drug database in a carousel is a very tedious and time-consuming job because you're assigning every drug to a particular location, and that's tedious work," Lay says.
Lay's team thought this could be done in a week, but after six hours they were ready to quit, he says.
For each of two carousels, there was a team consisting of a pharmacist and a technician working on this process, he says.
A final part of implementation involves testing and training.
"Testing is very important, and we purchased a test system where we can simulate the activities of the carousel with a personal computer," Lay says. "As we upgrade our information system and get new technology, we want to make sure this carousel is integrated and works with the other changes in technology."
Training can be one of the drawbacks to installing new technology.
"It's hard to simulate the carousel for training purposes because once you install the carousel, you need to use it," Lay says. "You can watch what employees do, but they might learn how to use it only when the carousel is up and running."
One training strategy would be to train "super learners" to use it first.
"Then we'd get a couple of people to use the carousel and a couple to use the packager, and we'd rotate people around," Lay says. "We had people trained 4-6 weeks ahead of time, and by the time we started with the carousel, they'd forgotten how to use it."
So the training had to be repeated, and it took a couple of weeks before employees were comfortable with it, Lay says.
"The real drawback is that training is hard to simulate, so it's on-the-job training," he adds.
Once a health system pharmacy receives approval to buy expensive new technology, such as carousel and packager equipment, it's time to put that money to the most efficient use, an expert says.Subscribe Now for Access
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