Alameda Health SystemPYXIS Automatic Dispensing Machines
Modernization
Finance CommitteeFebruary 8, 2018
Luis Fonseca, FACHE Chief Operating Officer
Diana Thamrin, PharmD, BCPSSystem Director of Pharmacy
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Agenda
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Project BackgroundCurrent State OverviewProject BenefitsImplementation TimelineExpected Total Project Cost & Financial PlanRequest
Automatic Dispensing Cabinets play a crucial role in safe medication delivery practicesBenefits of Automatic Dispensing Cabinets (ADCs):
Safe drug storage device Medications are accessible near the point of care Automated and accurate drug dispensing Tracks and records drug distribution Ensures patient safety Helps maintain regulatory compliance
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However, there are some growing issues that detract from the benefits ADCs currently offer
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Inconsistent Hardware
Inconsistent Software
Varying Contract Terms
End of Life
Increasing maintenance costs
Increasing Regulatory Risk
Patient Safety Concerns
Current State Issues
Alameda Health System Medication Dispensing Footprint(Current State)
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AHS Core Alameda Hospital San Leandro Hospital
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Term
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PYXIS Medstation4000, Server 2008
Windows 7 Operating System
End-of-Life 12/31/19
Contractual support ends
9/1/2018
PYXIS Medstation4000, Server 2008
Windows XP Operating System
Currently End-of-Life
Contractual support ends
4/1/2018
Aesynt/OmnicellAccudose
Limited contractual support or parts
available
Proprietary Operating System
Currently End-of-Life
Alameda Health System Medication Dispensing Footprint(Future State)
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AHS Core Alameda Hospital San Leandro Hospital
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Term
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PYXIS ESServer 11/1/2018 Ongoing leased
cabinet support for 60 months
Windows 10 Operating System
Supported hardware, Operating System,
and Software
PYXIS ESServer 1/1/2019Ongoing leased
cabinet support for 60 months
Windows 10 Operating System
PYXIS ESServer 8/1/2019Ongoing leased
cabinet support for 60 months
Windows 10 Operating System
Supported hardware, Operating System,
and Software
Supported hardware, Operating System,
and Software
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Successful modernization of ADCs will deliver additional value for key stakeholders
Pharmacy
Nursing
Technology
Patients
Standardize medication delivery process Standardize Medication Formulary Foundation for improving inventory management Active directory for employee access
Patient Centric – Bedside medication queuing Workflow Efficiency resulting in fewer clicks Controlled Substance Diversion prevention System-wide standardization for medication administration
Web based reporting HIT integration Central Virtual server Backup and Disaster Recovery
Improved patient safety High Quality Service Barcode Integration “Right Patients, Right Medication, Right Time”
Some concurrency of projects is acceptable– CareFusion Software, Interfaces, and Test Pyxis ES
cabinets must be ready by Feb 2019– Project must be complete prior to Epic Go-Live 10/1/19
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The ADC modernization effort is a prerequisite for the planned Epic EHR launch
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Proposed Implementation Timeline
Pyxis Med 4000 Contractual Support
2018 2019 2020
Highland Hospital
Alameda Hospital
San Leandro Hospital
Support ExtensionPyxis MedStationES – 60-Month
Lease Term
Pyxis Med 4000 Contractual
SupportEnd-of-Life OS Pyxis MedStation ES – 67-Month Lease Term
Omnicell End-of-Life Platform Pyxis MedStation ES – 69-Month Lease Term
4/1/2018
9/1/2018
11/1/2018
1/1/2019
8/1/2019
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Implementation CostsFY18 FY19
*San Leandro Construction $ (349,900) -IT Project Implementation resources $ 40,800 $14,400Pharmacy - $ 62,000Nursing - $310,000Subtotal $ 40,800 $ 386,400**Credit applied $ (150,000) $ (100,000)Total $ (109,200) $ 286,400New Approval Requested $ 177,200
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*Capital project approved and budgeted **Credit offered for upgrade to ES and achieving implementation timeline
ImpactImprovement Result
Nursing Bed-side medication queuing, Remote wasting and PYXIS ES Link improves efficiency for medication finding, retrieval, documentation and administration. Less time spent walking to the PYXIS machines and less phone calls to pharmacy for “missing” medications
7% reduction in non-value added time• 30 minutes saved in an 8
hour shift per RN• Annually, 74,500 Nursing
hours to dedicate to direct patient care
$5.35MPharmacy Active Directory, PYXIS ES Link, Integrated
medication formulary, and inventory management improves pharmacy efficiency by streamlining medication delivery, one central server for medication formulary and inventory management. Increased capacity of the PYXIS machines means less deliveries needed and less stock outs.
10% reduction in non-value added time• Annually 3,400 Pharmacy
Technician hours $210,200
340B Savings San Leandro Hospital cannot leverage 340B Drug Savings without an upgrade to PYXIS ES due to interface requirements for split billing software to maintain compliance
$300,000
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AHS Request
Approval to upgrade current PYXIS Medstation4000 to PYXIS ES– Enter into a contract term period of 60-69 months
effective March 1, 2018
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