Developing an innovative oral unit dose robot dispenser: Patient care performance and industrial perspectives

Abstract

Summary Introduction New technology has been embraced everywhere for improving the performance patient care. In particular, this concerns professional machine that features advanced and digital technology. There are four main reasons for the development of pharmacy unit dose packaging machine speeds up: an accurate dosage of the doses prepared, provided and administered (fewer mistakes which is especially important as ambulant care grows, requiring patients to self-administer drugs), a closer and more interactive follow-up for high alert drugs (management of the controlled ward stock [floor-stock]), enhanced productivity (saving nurses time and resources while reducing the need for time-consuming pharmaceutical manual processes), natural idea that the automated packaging system can be electronically integrated and connected to the web network. However, it is of concern that powdery pill residue can by produced by robotic dispensing equipment in pharmacies. The primary objective of the study is to present the pharmaceutical aspects of the development of an innovative packaging system for enabling the automation of the liquid unit doses preparation and the critical steps of compounding in two hospitals. Materials and methods To ensure mastery of the latest technologies and surround itself with better skills, our team of hospital pharmacists called on different experts in the fields of automation, computer electronics and machining, with whom it has regular partnerships. The group was committed in developing upgrading solutions appropriately for secure and accurate preparation of liquid unit doses. The innovative machine should be able to communicate to the software for drug prescription and dispensing. Doses produced speeds up to 200 units an hour complying with quality standards in European Pharmacopoeia. Supported initially by a grant from the French National Agency for the Promotion of Research (ANVAR), and then joined by the French National Center of Hospital Expertise (CNEH), our hospital continued to promote the project. Our innovative packaging system integrates digital elements of positioning and allowing software to make quantified displacements most adapted to maximise the compounding process (see video). Results The development of the APG/RMD818 High-Speed liquid unit dose packaging machine since 2003 was a technological milestone in pharmaceutical automation engineering. Coherence and pharmacotechnical performance throughout the designing, development and production stages of the packaging machine and its process control software system have been reported. Our machine is thus well suited to replace a “siloed” approach of preparation of liquid dose in each nursing unit (50 to 18,000 μL). Our developments have resulted in ordering a second machine for another hospital pharmacy producing 180,000 doses/year. Conclusion There have been a few robust evaluations of the hospital and industrial co-development in pharmaceutical automation engineering. With regards to other systems, our machine is innovative because it embarks up to 20 different oral solutions for each packaging run. Nevertheless, an add-on software module allows the automatic machine to directly import data from medical orders of the Hospital Information Systems (HIS). Our liquid unit dose packaging machine is a simple-to-use automated system that is supplied with powerful and stable calibrations that does not need any daily calibration control. The machine operator will support only the replacement of consumables, collection of patients cups and quality controls checks based on good manufacturing practices and hygiene requirements. Unlike solid oral dose packaging machine, the liquid unit dose packaging machine does not produce powdery pill residue likely to cross-contaminate medications. The budgetary evaluation for the use of the automatic liquid unit dose machine have been previously published. Thus, the present study and two machines used for production in two hospitals may convince anyone who questioned the value of the concept.