Parkview Health

Summary

Parkview Health is a multi-hospital system in Ft. Wayne, Indiana. They operate six pharmacies during the day, but centralize their pharmacy operations at night. Parkview used Talyst to implement pharmacy automation and medication tracking, enabling improved inventory control and a successful migration to a fully electronic medical record and bedside charting system.

Challenge

When Parkview Health began moving toward system-wide electronic medical record and bedside charting, they chose the Carecast® Hospital Information System. It included electronic patient charting and new systems for Admissions, Pharmacy, Radiology and Nursing. At that time, Parkview didn’t know what it would take to fully integrate their pharmacy operations into the new system, or what would be required to get barcoded doses to the patient bedside.

Parkview’s new director of pharmacy was hired a year into planning, and quickly determined that hospital executives had simply assumed barcoded meds would be available for use with the new information system. The Carecast charting module actually accommodated only a single barcode language, and one that is not widely used by drug manufacturers. Now, with six hospital facilities, 200,000 medication orders per month, and 40 totes of incoming inventory per day, the potential technical challenges of real pharmacy integration with six pharmacy locations seemed daunting.

Parkview explored their options and found two pharmacy distributor-based models that could be leveraged into their new system, but at best, they would deliver 60 percent of medications packaged and barcoded-and there would be an up-charge in medication costs. Parkview would then have to purchase the remaining 40 percent or barcode them in-house.

Solution

Ultimately, Talyst was able to step in and bridge the pharmacy information and operation gaps, helping to ensure the six facilities were operating together. Besides enabling virtually 100 percent barcoding, the Talyst components interface smoothly with Parkview’s Carecast and Pyxis® networks. Parkview’s director of pharmacy notes that “No one else had the capacity to connect all of these elements and run it with a single, unifying software package.”

The Talyst solution enables:

Improved Inventory Management. By tracking medications in all locations, the powerful AutoPharm® software allows a system-wide, real-time inventory. It also generates consolidated, daily electronic orders to the wholesale distributor.
Automated Oral Solid Packaging and Labeling. The AutoPack™ system automatically packs the oral solid medications, and can label them for patient-specific dosing.
Barcoded Virtually 100% of Medications. AutoLabel® prints transferable circle labels and Talyst-exclusive Flag Labels™ to ensure medications arriving from the wholesaler are barcoded before use.

Streamlined Order Picking and Verification. The AutoCarousel™ provides organized, access-controlled medication storage, improving pick accuracy while reducing staff time-on-task. The compact footprint of the AutoCarousel allowed the pharmacy to recover 30% of its working space.

Parkview’s comprehensive system has improved accuracy and efficiency at every step of the pharmacy operation. Patient orders are written by nurses or physicians, verified by pharmacists, and entered into the electronic medication administration record (eMAR) on the Carecast system. The medication becomes immediately available to nursing from stock in their local Pyxis cabinet. If the medication is not in the Pyxis stock, it is delivered from the pharmacy.

All of the barcoding activities are automatically coordinated by the AutoPharm software. The 350 most frequently-used medications are stored securely in the AutoPack, which can also package and label less common medications and special orders, such as half tablets.

Transferable circle labels and Talyst’s patent-pending two-part Flag Labels are used to ensure the bar code remains with the package and linked to the administered dose. Flag Labels are applied to ampoules and syringes, and circle labels are used for multi-dose medications like ointments, eye drops, and inhalers. At Parkview, generating and affixing barcode labels requires less than 80% of a full-time-equivalent employee for the entire six hospital system.

Parkview moved to the Cardinal Pyxis CUBIE™ model, and uses Talyst’s AutoPharm software to manage inventory and direct order picking and Pyxis replenishment through their two AutoCarousels. Replenishment orders represent 80% of all doses dispensed across the six hospitals, and can now be picked, scanned, and verified in a couple of hours by two technicians.

At the bedside, Parkview uses cart-mounted, wireless computers to scan patients’ wristbands and medications. This verifies the correct medication and triggers the medication charge.

Results

Parkview Health can already measure the success of the system:

Inventory reduction of $600,000, out of a total of approximately $2.5 million
Labor savings of 20 percent (pharmacist and technician) in the satellite hospitals
Improved order-to-delivery time from the stated goal of 90-minutes to an average of 60 minutes. The new target is 45 minutes
Faster pharmacist handling of new orders has reduced the time required for medication confirmation and authorization by 30%
A reduction in administration errors by as much as 75 percent, with higher overall confidence of delivering the right drug to the right patient

Automated wholesale ordering has eliminated nearly all inventory and ordering time by using automated functions in the AutoPharm software

By implementing a comprehensive tracking system and providing scan-ready barcodes at the patient bedside, Parkview has gained control of its inventory and is delivering a new standard of patient safety to its community.

Box Score

Facilities: 6
Beds: 800
Medical record transactions per day: Approximately 1 million
Pharmacists: 50
Pharmacy techs: 60
New medication orders/week: 50,000 average
Formulary: 2,700 line items
Pharmacy billings/month: Approximately $10 million
Pyxis locations: 120
Total On-Hand Inventory: $1.9 million average

Pharmacy System Components
GE/IDX Carecast
Cardinal Pyxis
Talyst AutoPharm
Talyst AutoPack
Talyst AutoLabel
Talyst AutoCarousel