What are your goals, Standard of Care or ROI?

Posted on September 3, 2014

By Alex Reinhardt, P. Eng.

I’ve had some recent discussions with potential customers that raised an interesting question:  What is most important to your organization, making a high percentage of doses with IV automation, or, saving money?  These are vastly different but both equally legitimate.  Let’s look at each in a bit more detail.

RIVA in a pharmacy

If your primary goal is patient safety, then the ideal situation is to make as many doses as possible using IV automation.  The inherent safety benefits of RIVA provides a marked reduction in potential erroneous doses leaving the pharmacy.  This results in the “standard of care” of RIVA made doses being higher than manual doses and therefore, as many patients as possible should benefit from this.  What this translates into is choosing drugs that are high volume movers, irrespective of the cost benefit of making the drug.

On the flip side, if the primary driver for automation is to save money, then that may result in a very different implementation approach.   In this case, the choice would likely come down to which drugs provide a higher payback in the case of bringing outsourced drugs back in-house, or which have a greater impact on reducing manual compounding labor.  A great example of this is one of our existing customers is starting to make a drug on RIVA that will save them $210/dose (compared to the anesthetist using only part of a bag and wasting the rest).  Even though they are only making about 100 doses/month, that’s a savings of $250,000 per year on one drug alone!  That is not too common nor is it likely to last a long time, but, it clearly illustrates the point.  In reality, it usually ends up being some combination of safety and cost recovery.  You may want to see my previous article “What are the Best Drugs to Automate?”  for some additional thoughts among these lines.

Ultimately, the approach you take needs to be determined based on current needs and future goals.  Adopting any form of automation, be it carousels, unit dose packagers, or IV compounding systems, is a significant undertaking involving change in many aspects of the business.  It is not something that can be done overnight, and normally ends up being a long term relationship; it’s much like getting married.  So, think about what the future goals are for your organization, and, look at pros and cons of various implementation options to figure out what works best for your facility.


Alex Reinhardt is Market Development Manager at Intelligent Hospital Systems, designer and manufacturer of RIVA – a Fully Automated IV Compounding System 


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