Going Global – ARxIUM’s International Journey

Posted on April 19, 2017

By: Irene Wasilewski,  Application Consultant

ARxIUM’s Director of Distribution Sales, Randy Kehler, recently presented to a group of students at the University of Manitoba’s International Management’s class. Mr. Kehler has been travelling the globe setting up distribution networks for ARxIUM’s fully automated IV compounding system, RIVA. The following is a summary of the presentation he provided.


ARxIUM was formed in 2015 when Intelligent Hospital Systems, Inc. acquired AutoMed Technologies, Inc., creating the most integrated pharmacy solutions company in the industry. Both companies were recognized as leaders in pharmacy technology, offering numerous best-in-category products and software solutions.

Founded in 2006 in Winnipeg, Manitoba, Intelligent Hospital Systems (IH Systems) began as a medical device company focused on the design and development of automated solutions for the hospital environment. Building upon pioneering research conducted at the St. Boniface Research Centre in Winnipeg, IH Systems developed RIVA technology, a fully automated IV compounding system for syringes and IV bags. Commercialized in 2008, RIVA is proven to enhance the safety of compounded medications while also lowering the cost per dose.

RIVA is used by hospital pharmacies to automatically and accurately prepare IV syringes and bags. The automation of repetitive and complex tasks reduces the incidence of errors and contamination. RIVA enhances the care of patients and the pharmacy team by improving the safety and accuracy of IV admixture compounding. By using state of the art safety features and practices, detailed electronic auditing, and integration to current hospital systems, RIVA ensures that hazardous and non-hazardous doses are accurate for pediatric, neonatal, and adult patients, along with oncological environments.

RIVA realized some early success in the North American market, proving the need for IV automation. One of the challenges in a new market is that the sales cycle for this type of technology can be extremely cyclical. The formation of ARxIUM brought stability to the company allowing additional time for existing and new markets to be explored and developed.

International Sales Strategy

There were a number of options reviewed when ARxIUM was reviewing the best path to international sales – distribution, sales agency, direct sales and/or partnerships. Up until this point, the vast majority of sales in the North American market had been direct sales. However, this approach required a large amount of overhead and investment to set up a network of sales executives. Therefore ARxIUM decided the best route forward was a network of distributors around the globe that each had relatively small, predefined goals. Moving forward, ARxIUM is considering adding sales agents and/or performing direct sales in some markets.


From a sales perspective, adoption of a new technology presents several challenges in addition to traditional challenges of new market entry.

As much as RIVA is innovative, it is inevitably disruptive. It forces the pharmacy to reconsider their standard workflow and adapt it to more closely match the workflow of manufacturing plants where automation has been a driver for decades. To optimize usage, pharmacies must reconfigure their processes around the technology. That means setting up new policies and procedures, staff training, developing interfaces, and most importantly addressing the impact to the culture.

RIVA also represents a brand new way of compounding that customers are not yet familiar with. The market for this technology does not yet exist because pharmacies cannot yet envision how it would fit in with their everyday demands. Our sales executives and distributors spend much of their time educating the market on why automation is important before a sale ever happens.

Another challenge is the confusion among the technologies that do exist. It can be easy to assume that any piece of equipment that performs IV compounding and contains a robot arm is the same as the next one. However, that couldn’t be farther from the truth. Today IV compounding technology is different in many aspects. Most are semi-automated at best, requiring a pharmacy technician to operate it at all times. RIVA is fully automated allowing the pharmacy technician to walk away and perform other tasks while RIVA compounds. As well, many of our competitors do not have as many features as RIVA and/or inferior air handling. Potential customers may have heard about issues relating to alternate IV technology and assume all IV technology is unreliable. Customers may also struggle to understand price differential between alternative IV technologies on the market without education based on value inherent to the design.

Pharmacy culture has also been a blocker in adapting innovative technologies. Strong leadership is required by early adopters to invest in something that will change the way compounding is viewed and done. Many sites may still view automation as the stepping stone to job loss, when in fact it should be used to deploy existing staff away from repetitive work to improving patient care.

The Future

Mr. Kehler continues to work on opening up new international markets for RIVA. Currently there is thorough coverage throughout Asia, Australia, Europe, the Middle East, and Mexico, with additional regions being explored and added on a continual basis.


Irene Wasilewski is an application consultant for Winnipeg, Manitoba and Buffalo Grove, Illinois-based ARxIUM, an industry-leading developer of pharmacy automation and workflow solutions.

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