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Alameda Health SystemPYXIS Automatic Dispensing MachinesModernizationFinance CommitteeFebruary 8, 2018Luis Fonseca, FACHEChief Operating OfficerDiana Thamrin, PharmD, BCPSSystem Director of Pharmacy1
AgendaProject BackgroundCurrent State OverviewProject BenefitsImplementation TimelineExpected Total Project Cost & Financial PlanRequest2
Automatic Dispensing Cabinets play a crucial rolein safe medication delivery practicesBenefits of Automatic Dispensing Cabinets (ADCs): Safe drug storage deviceMedications are accessible near the point of careAutomated and accurate drug dispensingTracks and records drug distributionEnsures patient safetyHelps maintain regulatory compliance3
However, there are some growing issues that detractfrom the benefits ADCs currently offerCurrent State IssuesInconsistent HardwareIncreasingmaintenance costsInconsistent SoftwareVarying Contract TermsEnd of LifeIncreasingRegulatory RiskPatient SafetyConcerns4
Alameda Health System Medication Dispensing FootprintAlameda HospitalSan LeandroHospitalPYXIS Medstation4000, Server 2008PYXIS Medstation4000, Server 2008Aesynt/OmnicellAccudoseSoftwareWindows 7Operating SystemEnd-of-Life 12/31/19Windows XPOperating SystemCurrently End-of-LifeProprietaryOperating SystemCurrently End-of-LifeContractualsupport ends9/1/2018Contractualsupport ends4/1/2018Limited contractualsupport or partsavailableHardwareAHS CoreContractTerms(Current State)5
Alameda Health System Medication Dispensing FootprintAHS CoreAlameda HospitalSan LeandroHospitalHardwarePYXIS ESServer 11/1/2018Ongoing leasedcabinet support for60 monthsPYXIS ESServer 1/1/2019Ongoing leasedcabinet support for60 monthsPYXIS ESServer 8/1/2019Ongoing leasedcabinet support for60 monthsSoftwareWindows 10Operatingc SystemWindows 10Operating SystemWindows 10Operating SystemContractTerms(Future State)Supported hardware,Operating System,and SoftwareSupported hardware,Operating System,and SoftwareSupported hardware,Operating System,and Software6
Successful modernization of ADCs will deliveradditional value for key stakeholdersPharmacy Standardize medication delivery processStandardize Medication FormularyFoundation for improving inventory managementActive directory for employee accessNursing Patient Centric – Bedside medication queuingWorkflow Efficiency resulting in fewer clicksControlled Substance Diversion preventionSystem-wide standardization for medication administrationTechnology Web based reportingHIT integrationCentral Virtual serverBackup and Disaster RecoveryPatients Improved patient safetyHigh Quality ServiceBarcode Integration“Right Patients, Right Medication, Right Time”7
The ADC modernization effort is a prerequisite forthe planned Epic EHR launch Some concurrency of projects is acceptable– CareFusion Software, Interfaces, and Test Pyxis EScabinets must be ready by Feb 2019– Project must be complete prior to Epic Go-Live 10/1/198
Proposed Implementation Timeline201820192020Highland HospitalPyxis Med 4000 ContractualSupportPyxis MedStationES – 60-MonthLease TermSupport Extension9/1/20188/1/2019Alameda HospitalPyxis Med 4000ContractualSupportEnd-of-Life OS4/1/2018Pyxis MedStation ES – 67-Month Lease Term1/1/2019San Leandro HospitalOmnicell End-of-Life PlatformPyxis MedStation ES – 69-Month Lease Term11/1/20189
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Implementation CostsFY18*San Leandro ConstructionFY19 (349,900)- 40,800 14,400Pharmacy- 62,000Nursing- 310,000Subtotal 40,800 386,400**Credit applied (150,000) (100,000)Total (109,200) 286,400IT Project Implementation resourcesNew Approval Requested 177,200*Capital project approved and budgeted**Credit offered for upgrade to ES and achieving implementation timeline11
ImpactImprovementNursingBed-side medication queuing, Remotewasting and PYXIS ES Link improvesefficiency for medication finding, retrieval,documentation and administration. Less timespent walking to the PYXIS machines andless phone calls to pharmacy for “missing”medicationsResult7% reduction in non-valueadded time 30 minutes saved in an 8hour shift per RN Annually, 74,500 Nursinghours to dedicate to directpatient care 5.35MPharmacy340B SavingsActive Directory, PYXIS ES Link, Integratedmedication formulary, and inventorymanagement improves pharmacy efficiencyby streamlining medication delivery, onecentral server for medication formulary andinventory management. Increased capacity ofthe PYXIS machines means less deliveriesneeded and less stock outs.San Leandro Hospital cannot leverage 340BDrug Savings without an upgrade to PYXISES due to interface requirements for splitbilling software to maintain compliance10% reduction in non-valueadded time Annually 3,400 PharmacyTechnician hours 210,200 300,00012
AHS Request Approval to upgrade current PYXIS Medstation4000 to PYXIS ES– Enter into a contract term period of 60-69 monthseffective March 1, 201813
Feb 22, 2018 · 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.
