Technology and medicine have had a tumultuous, uneasy relationship. Medical professionals rightly take pride in their skills and competencies and are often reluctant to admit, like other professionals, that there are circumstances or procedures for which a machine might be their equal.
One such circumstance is the intravenous (IV) compounding process, which evidence suggests still involves the serious potential for human error. Technological advances in intravenous robotics reduce such risks.
Risks of Outdated Compounding Practices and Procedures
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It is acknowledged as a fact that accurate, cost-effective compounding is a critical healthcare function. And there is no doubt that great improvements have been made from those days when nurses prepared the compounds “free-hand” right in the hospital rooms.
Yet IV compounding processes remain one of the most complex and dangerous of pharmacy operations, and often technology is only reluctantly adopted. Reliable studies have measured mislabeling errors at 1% of IVs, and compounding error rates of up to 9% in prepared solutions.
There are many misconceptions regarding the proper and positive role iv automation might play in making this process safer, more precise, and more cost-efficient.
Myth: IV Automation is Too Expensive or Too Big.
Like other forms of technology, IV automation technology has evolved and now offers a more cost-efficient solution. Hundreds of hospitals now use IV automation to produce millions of accurate and sterile preparations annually. Many hospitals realize an acceptable return on investment within two years. And as technology prices have moderated, so have the space requirements for IV automation equipment.
Myth: Robotics Cannot Compete With Trained Professionals.
People make mistakes, and that includes the highly trained, certified, licensed, bonded, and insured medical professional. Many studies confirm IV error rates between 1% and 9%. A repeated finding across several studies attested to routine drug selection error and the consequent mislabeling of compounded preparations.
Research shows that the accuracy of IV medication doses increases when robotics are used. IV robots will precisely ensure accuracy and produce more consistent preparations than humans.
In addition, the sterility of IV preparations is enhanced through robotics by eliminating direct bodily contact with or particulate contamination of sterile solutions.
Myth: Hospitals with “Smart” pumps and Bar Codes are Sufficiently High Tech.
This is an example of comparing apples and oranges. While it appears that a substantial majority of hospitals use bar code medication verification (BCMA) technology, it is crucial to note that BCMA cannot detect errors in the compounding process. So if a compounding error is made in the pharmacy, BCMA will not detect it. Unlike IV automation, then, BCMA and smart pumps do not address the compounding process itself.
Myth: IV Automation Does Not Play Well With Others.
System interfaces remain an issue, though significant improvements have been made over the past few years. The issue of system interoperability is less of a myth than the others.
In evaluating competing IV compounding processes, it is best to first perform a risk assessment of current compounding procedures to establish a benchmark and gauge the propriety of the status quo. That benchmark can then be compared with the projected results of an automated IV system.
Industry and societal trends seem to suggest that safer and more accurate IV compounds will be demanded. IV automation is a reliable, cost-effective means to achieve safety, accuracy, and productivity goals in the problematic IV compounding process.
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