DRAFT ::: Document1 HIMSS15 Pharmacy Script 4/2015 Contents HIMSS15 Pharmacy Script 4/2015 .................................................................................................. 1 Introduction .................................................................................................................................... 3 1-“Health System Central Pharmacy” ......................................................................................... 3 1.1_ Central Sterile Compounding (DoseEdge – Baxter.1)~.................................................... 3 2-“Hospital Facility Pharmacy” – Part 1 of 2 ............................................................................... 6 2.1_ID badge authentication (HID.1)~ ..................................................................................... 6 2.2_Alaris Infusion Viewer (CareFusion.1) .............................................................................. 7 2.3_networking infrastructure (Extreme Networks.1)~ .......................................................... 7 2.4_Central Controlled Substance Storage (AutoVault Mini & Autocool – Talyst.1) .............. 7 2.5_ADC Replenishment (AutoCarousel Mini – Talyst.2) ........................................................ 8 2.6_Temp monitoring (Arista.1)~ ............................................................................................ 9 3-Facility Sterile Compounding Room ....................................................................................... 10 3.1_Compounding (Talyst.3)~ ............................................................................................... 10 3.2_Labeling (Zebra.1)~ ......................................................................................................... 10 3.3_Real Time Status View of IVs for Pharmacy (BBraun.1)~ ............................................... 10 3.4_TPN Compounding (BBraun.2)~........................................................................................ 5 3.5_Optimized IV Compounding (CareFusion.2) ................................................................... 11 4-“Hospital Facility Pharmacy” – Part 2 of 2 ............................................................................. 12 4.1_Medication Tracking and Delivery (CareFusion.3) ......................................................... 12 4.2_Video Visit (Skylight.1)~ .................................................................................................. 13 5-Outpatient Pharmacy ............................................................................................................. 13 5.1_E-prescribing (HID.2)~~................................................................................................... 13 5.2_M5000 Robot (Omnicell.1) ............................................................................................. 14 5.3_Retail Security (Cbord.1) ................................................................................................. 15 5.4_Medication Compliance (eMedonline.1) ........................................................................ 16 Page | 1 DRAFT ::: Document1 Conclusion ................................................................................................................................. 17 Appendices.................................................................................................................................... 18 A-Setup procedures for Next Tour ............................................................................................ 18 B-Sample Labels to be Printed .................................................................................................. 18 C. Map of Room (not to scale) .................................................................................................. 19 D-Furniture & Fixtures To Obtain .............................................................................................. 20 E-Furniture & Props:.................................................................................................................. 21 Page | 2 DRAFT ::: Document1 [any text in blue or red will not be SPOKEN in the script, red text is for actor performance, blue text is for organizing/structuring the script, green is directorial for the voice. This script requires a minimum of 5 actors: 1. Central pharmacy a. tech (Actor 1) b. pharmacist (Actor 2) Introduction [Prop Listi] Hello, welcome to the Intelligent Hospital Pharmacy. In this demonstration you’ll see a Pharmacy staffed with pharmacists and pharmacy technicians who perform important and complex tasks while seeing examples of technology improving efficiency and accuracy to help ensure the 5 Rights of medication safety are made possible <brief pause> the right medication, to the right patient, at the right time, via the right route, and at the right dose. 1-“Health System Central Pharmacy” [Slide: hub and spoke video graphics] We begin our tour in the Central Pharmacy. This area is designed to support many facility based pharmacies within a multi-hospital health-system. If we imagine a wheel with many spokes, this pharmacy represents the hub, of a “hub and spoke” pharmacy services model. A “hub-and-spoke” model is more common now because it can improve efficiency by centralizing laborious operational functions and drug inventory that might otherwise be duplicated at each facility. 1.1_Central Sterile Compounding (DoseEdge – Baxter.1)~ [Technician 1: garbed appropriately for sterile compounding – stands in front the DoseEdge System PrepStation, ready to start his/her shift. The DoseEdge System PrepStation (touchscreen and printer on a cart, with a foot pedal on the ground) is just to the right of the hood. The camera stand and honeywell barcode scanner are in the hood and zebra printer, positioned on the right side of the preparation area. There are specific storage bins outside of the hood, containing the necessary ingredients and supplies to make the doses. The PrepStation touchscreen has the login screen showing. ii ] [Slide: slide 1] The compounding of IV admixtures or oral liquid doses is a complex process that is becoming increasingly governed by regulatory agencies. Meeting these regulations is a challenge. We recognize that while technology is not intended to replace the knowledge, judgment or expertise of pharmacists and pharmacy technicians, systems like these help manage the process by tracking each step and capturing key elements in the database should the need ever arise later to examine the history of the dose. Let’s watch as one of these systems guides the pharmacy technician through the process to begin to prepare dosesiii. Page | 3 DRAFT ::: Document1 [Slide: #3 from deck, be of the technician and the monitor] After entering his/her login credentials using the touchscreen, the pharmacy technician sees a number of required tasks that must be performed to ready the compounding environment clean and safe before compounding can begin. For example the first task that the must be completed is cleaning of the IV hood, a routine process done many times throughout the day. If this first step is not completed, a pharmacy supervisor will be alerted. [Slide 4 - play Audio File in male voice] [DoseEdge System has voice activated and announces that there are Tasks to be completed. Actor wipes down hood, and then taps the screen to close out the Tasks. He/she walks over and picks the required ingredients and supplies from the storage bin, bringing it to the hood.] [Slide 5] Once this and other similar preparatory tasks are checked off and completed, the user is ready to begin preparing doses from the queue that lists all the doses awaiting preparation. Arranged and sorted in microbatches, doses can also be arranged by priority, like stat, or first doses. [Actor touches the PrepStation computer. The screen changes, showing the doses ready to be made, arranged in microbatches (grouped according to drug, dose and volume).] [Slide: slide 6] The technician selects the “Prepare Dose” button and a label is immediately printed. On the monitor you’ll notice the display shows a list of actions that are to be followed on the right side of the screen, and the list of ingredients needed to prepare the dose on the left. [Actor removes label from printer, then scans the barcode of the multiuse vial. A warning alert appears on the screen.] [Slide: 7] The system will now check to make sure the product intended for use is correct. In this case, the pharmacy technician has scanned the product bar codes on the medication and the system has determined that it was not the right ingredient for this dose. An onscreen alert displays and has stopped the technician from proceeding. [Narrator emphasis here] Error averted! [Slide: 8] [Actor looks at screen and then at the vial. Realizing he/she has the wrong medication, he/she walks away from the hood and puts the vial back in the correct area] [Slide: 9] The technician tries to scan again with the correct medication this time, and the system allows the process to continue to the next step of withdrawal of the appropriate volume from the vial Page | 4 DRAFT ::: Document1 into a syringe. The label is affixed to this syringe and placed onto the camera stand along with the ingredient vial. Using the foot pedal, high resolution images of each item will be taken. [Slide: 10 & 11] Images are captured to document steps in the preparation process. In most cases, an image is used to document the amount of fluid drawn from a specific source container, including visual confirmation of the lot number and expiration date. These images are then made available for remote pharmacist verification. [Slide: 12 & 13] This system also offers a delivery tracking ability of the location of each product made all the way to the nursing floor. Lost or missing doses can be tracked down and located without interrupting pharmacy operations. Likewise, a full audit trail is permanently stored in the database allowing for the retrieval of the comprehensive history of every dose made. Visibility of the entire dose preparation and dispensing process helps promote dose preparation safety, reduction of waste through better expiration date management, and overall enhanced productivity within the pharmacy. [Actor scans the barcode on the label to complete the process. He/she pauses to look at the label of the dose.] [The screen then reverts back to the dose queue, and the actor selects another dose for preparation. The actor takes the label and starts to prepare another dose. A Slide of tracking and dose search shows on screen.] [Actor continues to prepare doses, placing completed doses in a blue bin.] 1.2_Central TPN Compounding (BBraun.1)~ [Hardware: Jessica Pitt will again work with GermFree for a hood] [Props: ______________] [Slides: ______________] [Technician #: garbed and gowned inside the compounding lab area, holds up label] We will now show you another system that helps manage the production of “total parenteral nutrition”, also known as TPN. The set-up of the hood and compounder is a critical process. The hood cleaning has been documented, and this compounding pump has been accurately calibrated. The ingredients have also been hung inside the hoodiv and connected to the compounder using this bar-code scanner. Because an accidental swap of the tubing is an easy mistake to make, this scanning step verifies the correct ingredients are hanging on the correct tubing line and helps ensure a proper line tracing is done for each connection. And with barcode scanning, the system will also capture the lot number and expiration date directly from the barcode to eliminate the need for manual transcription or data entry and will even alert the user if something is expiredv. Page | 5 DRAFT ::: Document1 [Technician 1: hangs ingredients, scanning the bar codes on the lines of the transfer set and the corresponding source containers. Then holds up empty 2-liter bag with barcode label, scans the bar code, then presses the “Start” button on the compounder] The pharmacist has just received electronic orders for a pediatric TPN. A patient specific barcoded label has been printed and placed on the empty bag. With one simple scan of this patient specific label, the pump is queued with the exact formula that was ordered by the pediatrician, eliminating any opportunity for error with manual data-entry. All that’s left to do now is press START on the compounder and wait for the pumping to finish. <brief pause> Upon completion of pumping, the technician takes the completed bag off of the compounder and readies it for delivery to the pediatric wing across town. Later, we will see how an order like this is actually generated at the bedside using a tablet computer. 2-“Hospital Facility Pharmacy” – Part 1 of 2 We will now leave the Central pharmacy, and enter the Facility pharmacy to your < insert directional > . So as we described earlier about the hub and spoke model of pharmacy distribution, if the central pharmacy is the hub, the facility pharmacy we’re entering now represents one of the spokes on the wheel. 2.1_ID badge authentication (HID.1)~ {Suggest leveraging this quick use case to increase awareness of increased cyber security in every demo room where a tablet is being used}. [Hardware: NFC Tablet, Mobile Phone, ID Badge] [Actor #1: Picks up/ Holds out the Tablet] We begin our tour in the pharmacy by demonstrating the importance of security in this ever increasing world of mobility. To address this issue, the intelligent pharmacy employs <emphasis> two factor authentication to log in to any systems and application. [Slide 1: Screen shot of ActivID Tap Application] [Actor #1: Enters there reduced complexity domain password and then Taps their ID Badge to the back of the Tablet for a second factor] With a single tap of this smart identification card, the innovative technology inside the card both generates and transmits a One-Time- password without the inconvenience of re-keying. Elevated security that’s efficient is a must-have in the environment of care and because this card is ‘bound’ to the device, should a user lose their card, there’s never a risk of someone else being able use it to access any of the pharmacy applications. [Slide 1: Screen shot of Authentication] Page | 6 DRAFT ::: Document1 2.2_Alaris Infusion Viewer (CareFusion.1) [Hardware: ______________] [Props: ______________] [Slides: ______________] Pharmacists can now view near real-time infusion status data for all large volume and syringe infusions administered throughout their hospital or health system. Using information provided by this infusion viewer, Pharmacists can make timely, informed decisions to improve medication safety, as well as infusion preparation and management. [Pharmacist Actor comes back to computer workstation / power-point Screenshots of Infusion Viewer displayed on screen] For example, shortly after an infusion begins anywhere in the hospital, the IV pump will communicate wirelessly to a central server that will update the “Infusion Viewer” you see here on the monitors. From this web-based dashboard, the pharmacist now has visibility to patient-specific infusion data, due to the dashboard’s integration with the hospital’s Admission, Discharge, and Transfer system (or ADT). This helps the pharmacist by providing key patient demographic and location information, such as patient name and room number, to each infusion that is currently being administered. In addition, the dashboard clearly identifies all infusions that are violating a safety software “soft” limit and the violation that occurred, as well as identifies those infusions that are not being protected by dose error reduction software at all, which show up as “Unknown” in the Infusion drug name column. [Pharmacist Actor points to yellow G badge in the Infusion Name column, as well as an infusion with the name ‘Unknown’ in the same column] This gives the pharmacist the opportunity to review the current dose, rate, concentration, and duration of running infusions - as well as review overall safety software compliance – to help identify potential medication errors and ensure optimal care coordination between both Nursing and Pharmacy. 2.3_networking infrastructure (Extreme Networks.1)~ [____________________] [Slide 1] < insert copy about networking infrastructure > 2.4_Central Controlled Substance Storage (AutoVault Mini & Autocool – Talyst.1) [Pharmacist 1: Selects an item from the pick queue using the mouse to select. A label prints from the barcode printer. The appropriate AutoVAULT door opens (this could be an AutoVAULT door or a door on the refrigerated AutoCool +H (Helmer). Page | 7 DRAFT ::: Document1 Validates the picking location. Picks the appropriate number of items from the bin. Scans the barcode of the item. the label to the product. May or may not perform blind cycle count] Attaches [Slide 1] As just demonstrated with medications picked from pharmacy shelving for remote ADC replenishment, the same concept applies to the replenishment of refrigerated or nonrefrigerated medications that require computer controlled storage. Orders for remote pharmacies, satellite pharmacies, outpatient clinics and specialty clinics can be automatically queued up from the pharmacy system. A controlled access vault or locking refrigerator like this uses barcode scanning to ensure control and recording of every transaction into and out of these controlled access devices. [Slide 2] For this demonstration, the technician selects an item for picking. The appropriate door is unlocked, the technician scans the item to confirm the right medication is picked and the door is then re-locked. All transactions, including user access are recorded, the inventory is updated, labels are printed, and the picking can continue. [Slide 3] With the integration to a perpetual inventory system and remotely located ADC's, workflows can be automated to help manage the restocking of controlled medications and ensure closed loop replenishment while documenting chain-of-custody at each step of the way. [Slide 4] And in the case of dealing with a controlled substance like morphine or vicodin, if a discrepancy were to occur signifying potential diversion, the investigation into the reason can easily occur to ensure an appropriate and accurate resolution. 2.5_ADC Replenishment (AutoCarousel Mini – Talyst.2) [PHARMACIST 2: Technician signs into AutoPharm.] [Slide 1] Automated dispensing cabinets, or ADC’s for short, located throughout the hospital need frequent refilling. Just like the refill process being done at the Central Pharmacy for the fast movers, this pharmacy also refills the ADC’s and the focus here is on refiling the slow-movers and specialty medications that the Central pharmacy didn’t carry. [Slide 2] For the sake of this demonstration…. Page | 8 DRAFT ::: Document1 [PHARMACIST 2 starts the picking process – replenishment for Pyxis order. The AutoCarousel spins to the proper location and the tic-bar lights up to identify the location of the bin to pick the item. Barcode prints. Technician picks and scans the item to insure the proper medication. The technician packs and labels medication.] [Slide 3] …we are utilizing an automated mini carousel that is more typical in small environments. Larger carousels can be seen on the main floor of the show. [Slide 4] Additionally, medications and components to support pharmacy workflows such as IV compounding and kitting can also be handled here for storage and picking. [Video: show 15 second video without sound] [Actor: interacting with carousel, showing light to pick, barcode scanning] High-density storage systems like these can be configured with multiple widths, depths, and heights, depending on the physical constraints of your pharmacy and the work activities that you perform. Integrated with an enterprise wide perpetual inventory system, all orders can be queued for an efficient workflow. Once the technician selects the order, the AutoCarousel will spin to the designated location, the light will light up on the correct bin from which the technician will pick the medication from. The technician uses the medical grade barcode scanner to scan the product and the label to confirm the proper item is picked. The carousel is then ready to rotate to the next pick, and the sequence starts again. With an automated carousel like this, pharmacy stock can be stored in the carousel for better inventory management & tracking with the intent of keeping just-in-time inventory on hand, thereby preventing stock outs while avoiding overstocking. This carousel can be used to send patient specific first-doses and receives refill data from an ADC if ever there’s a stock out needing immediate attention. The system will also send order recommendations to the pharmacy buyer which will then be sent to the wholesale distributor, ensuring this machine has the desired “just in time” inventory at all times. 2.6_Temp monitoring (Arista.1)~ [Hardware: put module on Talyst autocool] [Props: ______________] [Slides: actor can receive an alert that temperature or humidity has deviated within the room or within an asset and go to the screenshot for dashboard notifications] Real Time monitoring of room/refrigerator/freezer/deep freezer environmental conditions with real time display of data via dashboards and other user interfaces. The temperature tags utilize Page | 9 DRAFT ::: Document1 existing Wi-Fi infrastructure to transmit the data for storing and processing. Alerting of abnormal conditions is achieved via email, SMS or other API. ###transition1 from main room to IV Compounding room We will now shift your attention to the compounding area to your right. This area represents a clean-room area designed to adhere to USP797 standards for anticipatory batch compounding of sterile preparations for the entire health-system. 3-Facility Sterile Compounding Room 3.1_Compounding (Talyst.3)~~ [Props: ______________] [Slides: ______________] The next solution you see is aimed at streamlining sterile and non-sterile compounding within your pharmacy. This solution provides a process for medication preparation, verification and inventory management, all bar coded to manage complex multicomponent orders for the IV Room compounding needs. This module offers a preparation, verification, and check software component to your compounding areas while also tying into the inventory management and reporting capabilities of. It can be used in your inpatient pharmacy or satellite compounding locations and can be integrated to existing compounding solutions. ###transition2 from main IV Compounding room to Patient Care Area We will now shift your attention from the compounding area to the monitors. 3.2_Labeling (Zebra.1)~ [Technician 1 holds a zebra scanner and interacts with a printer or print label; presses scanner button and outputs a label from a zebra printer, applies to a medication, and then scans the medication to note when the meds were prepared. ] [slide ##] The use of barcode scanning is very important throughout the intelligent hospital. Many different processes rely on barcode scanning to help ensure accuracy and simplify documentation. To achieve accuracy and efficiency, scanners need barcodes printed clearly with a high degree resolution. And when working inside a clean room like this, it is especially important that barcode scanners and printers are produced with medical grade plastics to ensure a clean and sterile pharmacy environment and use power supplies built specifically for hospital environments. 3.3_Real Time Status View of IVs for Pharmacy (BBraun.2)~ [Hardware: ______________] [Props: ______________] Page | 10 DRAFT ::: Document1 The pharmacist working here in this IV Room has a special system that provides us with realtime infusion information on when IVs are due for our patients. [Slide 1: TECH 2 point to last column with colors] As you can see the color coding provides a quick visual as to what needs to be worked on first, allowing staff to anticipate what’s needed before the patient runs out. And because it ignores things like Piggybacks or Boluses, this system doesn’t direct staff to produce something that isn’t actually needed. [Slide 1: Actor points to Time Thresholds on monitor] This screen allows staff set preferred time thresholds to better achieve “just in time” production which will decrease waste. Warnings set for 30 minutes and less will appear in red. Reminders for 60 minutes and less, will appear in yellow. This approach allows you to proactively prepare IVs before they’re due the patient. [Slide 1: Actor point to last column with red colors] As you can tell by the red indications on this screen, there are a lot of IVs now due. In a busy hospital it can be frustrating receiving phones calls from nursing asking for their IVs that about to run out. That will not happen with this system. Pharmacy technicians also appreciate not having to perform IV rounds anymore, allowing them to focus on more important duties. 3.4_Optimized IV Compounding (CareFusion.2) IV compounding isn’t complete once the IV has been compounded. Currently, most Pharmacies lack the visibility… [Slide: CareFusion_Pharmacy2.5_visibility.png] …into where the IV is going, was it used, and if it does return to the pharmacy unused, can it be re-used or will it be expired? Through technology,… [Slide: CareFusion_Pharmacy2.5_technology.jpg] …patient specific medication can be tracked from the pharmacy to any patient care area. <brief pause> When a patient specific IV is not administered because the IV orders have changed, been discontinued or the patient has been discharged, the medication can be returned to pharmacy. This results in thousands, if not millions of dollars for some health systems, going down the drain. <brief pause> This technology helps manage… [Slide: CareFusion_Pharmacy2.5_manage.png] [Actor points to monitor showing screen shot] Page | 11 DRAFT ::: Document1 …unused IV medications returned to the pharmacy by storing them as inventory. If an identical IV medication is requested before its expiration date, the software will notify the technician of the already-existing IV medication and allow re-issue. If the medication is not usable, it can be appropriately documented and discarded as waste. <brief pause> With changing state board of pharmacy requirements and increased need for documentation, consider technology that provides a log… [Slide: CareFusion_Pharmacy2.5_log.png] [Actor points to monitor showing screen shot] …with detailed information on all IV preparations compounded for administration to patients. Information captured includes the complete IV preparation process, including pick, prep, check and final check information. In addition, reports include the NDC, Lot number and expiration date information. All critical information should a recall of one of the medications ever occur. 4-“Hospital Facility Pharmacy” – Part 2 of 2 <insert transition sentence, “we now shift your attention away from the IV compounding room back into the center of the Hospital Pharmacy”> 4.1_Medication Tracking and Delivery (CareFusion.3) In your typical pharmacy, the phones would be ringing non-stop! Here, there are no phone calls from Nursing down to Pharmacy for missing medications, thanks to a delivery system that uses barcodes to track and verify the delivery of medications to patient care areas. [Actor: Show outbox full of medications ready to be delivered. Technician scans meds with handheld.] [Slide 4.1_Carefusion_Pharmacy_outbox_delivery_bin.png] <brief pause> When medications – like the IV that was just compounded and checked – are ready to leave the pharmacy, a technician simply scans… [Slide CareFusion_Pharmacy4.1_scans.bmp] …the meds ready for transport and a delivery list is automatically … [Slide CareFusion_Pharmacy4.1_automatically.bmp] …created, prioritized by order urgency. <brief pause>They are now ready to head out the door… and Pharmacy management can review… [Slide #: CareFusion_Pharmacy4.1_review.bmp] …the status of all deliveries to help manage workflow and respond to Nursing if they do call. Page | 12 DRAFT ::: Document1 4.2_Video Visit (Skylight.1)~ [Hardware: ______________] [Props: ______________] [Slides: ______________] This interactive video visit system connects patients with people outside their room including family, friends, physicians and even the pharmacist. The HIPAA-compliant videoconference platform is the ideal tool to deliver a better patient experience while saving time for the hospital staff. While _____Interactive allows the patient to get prescriptions filled prior to discharge the Video Visit component allows the pharmacist to do a consultation for medication information and instructions via videoconference, creating better adherence to medication regimens, enhanced care coordination, and better prepared for transition of care. ###transition2 from main Patient Care Area to Outpatient Pharmacy We will now shift your attention to outpatient pharmacy area to your left. This area represents a community pharmacy services operation where medications are being provided to patients, employees and walk in customers. 5-Outpatient Pharmacy 5.1_E-prescribing (HID.2)~~ [Hardware: PC/ workstation/ computer, ID Badge with contact chip and One Time Password generator, Desktop reader, Desktop bio sensor] [Slide 1: Screen shot: Authentication session of an e-Prescribing E H R session] [Actor#1: Sitting at a desk or counter to input the prescription electronically] This busy pharmacy receives prescriptions for all types of medications and from anywhere throughout the medical system and surrounding community. And fewer and fewer prescriptions these days are being written on paper, rather they are being received electronically from electronic ordering systems. This intelligent hospital employs a system that enables physicians to prescribe controlled substances electronically right from the hospitals electronic medical record. This might sound straight forward, but because the DEA requirements to write an electronic prescription for a controlled substance require two factors of authentication to be established, the intelligent hospital uses a system that seamlessly integrates into the EMR and allows the prescriber to authenticate his or her identity in one of 3 ways: [Actor#1: Holds up ID Badge, inserts it into desktop reader, types four digit PIN 1234] The first way allows the prescriber to insert their ID credential for presentation of their digital certificate, and then they type in their personal PIN number. Page | 13 DRAFT ::: Document1 [Slide 2: Screen shot: Identity accepted] The second method, the prescriber can initiate a One-Time-Password from the certified credential, types in six numbers. 123456 [Actor#1: Holds up ID Badge, types six digit PIN 123456] [Slide 3: Screen shot: Identity accepted] And lastly, the third option for authentication allows the prescriber to a use a biometric identifier like a fingerprint to matches the prescriber to their profile. [Actor#1: Holds places index finger on the sensor] [Slide 4: Screen shot: Identity accepted] [Slide 5: Prescription successfully sent to the Pharmacy] And because any one of these three authentication methods meets the DEA requirement for authentication, users can choose their preferred authentication method to electronically prescribe medications right from their computer desktop. 5.2_M5000 Robot (Omnicell.1) [Hardware: The dimensions of the robot are 30 inches wide x 35 inches deep x 80 inches high and weighs 1000 pounds. The robot must be lifted and moved by forklift. The robot should be located near an air source against a wall if possible.] We now shift your attention to this demonstration. Medication adherence and its role in readmissions is getting much attention as health care reform shifts the way services are measured and reimbursed. Providing… [Omnicell_-_M5000 Promotional Video Final.mp4 -- 1:40-1:53] …patients with medication adherence packaging is one proven way to address this issue. Multiple medication adherence blister cards are designed to improve a patients compliance to their medication regimen by clearly organizing and labeling medications by time of day, and day of the week, making it easy to know what to take and when. [Omnicell_-_M5000 Promotional Video Final.mp4 -- Video: 36- :47] It takes time and resources for the pharmacy to prepare such cards. But now there’s an easier way. [Slide: PAUSE ON IMAGE “OMNICELL_PHARMACY_M5000”] What you are seeing here is a demonstration of the integrated vision system for the first pharmacy automation system that fully automates the fulfillment of these multiple medication adherence blister cards. This is just one of the featured technologies that help verify the correct Page | 14 DRAFT ::: Document1 pills are being selected by the pick and place robot. As you can see here, the robot is selecting and sorting the pills by color. [Omnicell_-_M5000 Promotional Video Final.mp4 -- Video 00:44-1:04] As part of a full pharmacy automation system, the visioning system reads the size and shape of the pill and matches it to the NDC profile in the machine’s software. This is just one of features that audit the medication from the time it’s entered into a cassette until it leaves the machine in a filled, sealed, and labeled card. 5.3_Retail Security (Cbord.1) [Hardware: ______________] [Props: ______________] Every retail environment needs to keep close tabs on what is happening at the registers. [Actor: holds up ID badge] [slide 1] This employee recently used their intelligent hospital identification badge to pay for her medication, a magazine, and a snack. While reviewing the receipt that was emailed to her after the transaction, she noticed she was overcharged [Actor: Employee points to monitor showing screen shot of transaction history on phone in GET] [slide 2] Luckily, we have a full audit trail and surveillance of the transaction just a few clicks away. [slide ##: Monitor shows FSD at computer querying transaction in POS Video Security] After a quick search, a manager brings up video footage… [slide 3] …and a receipt for the transaction. Here you can see… [slide 4] …that she indeed only purchased one magazine, but… [slide 5 – animation accentuates different parts of the screen shot]] Page | 15 DRAFT ::: Document1 …the receipt shows two. The manager corrects the situation and credits her for the error. A cashless system with point-of-sale surveillance allows you to manage retail activity with tight security controls in place. 5.4_Medication Compliance (eMedonline.1) [Actor #1: Pharmacist looks at the desktop monitor to review the patient’s medication compliance record. Then walks over to the patient waiting to pick up his meds. They both check the patient record on the phone screen. (See Actor #2).] [Actor #2: A patient waits at the counter, ready to pick up his medications. He is holding a smartphone with a medication compliance app on the screen showing his compliance history or body map or list of meds.] [Props: Desktop monitor showing screen shot of clinical interface (depicted in Slide #2 and/or #3). Smartphone with a medication compliance app on the screen showing his compliance history or body map or list of meds (eMed can provide prop).] Today, the Intelligent Pharmacy goes beyond the walls of the pharmacy or hospital by managing medication compliance for outpatients in the ambulatory and home setting. [Slide 1: medication management platform] Smartphones connect any medication event – pill, injection, inhaler, eyedrops – seamlessly to the pharmacy information system , an electronic medical record, or care management system, delivering codified, actionable data to the right place at the right time. [Slide 2: Screen shot of patient medication compliance record] These new digital platforms engage patients in self-efficacy and give the pharmacist an unprecedented view into the patient’s longitudinal care. Server based software delivers codified adherence and outcomes data [Slide 2.1: animation fades in from Slide 2 to reveal the popup window depicted in the screen shot] …in structured format that facilitates interoperability throughout the healthcare system. [Slide 3: Screen shot of NLP showing codified outcomes data] Natural language processing is used to capture and codify symptoms and side effects in addition to the compliance data collected. This aggregate data can be mined to assess drug use and distribution, track supply chain of custody, identify adverse effects specific to a given indication, and compare drugs in a therapeutic class or formulation. [Slide 4: Depiction of longitudinal care with actionable, codified data] Such end-to-end solutions create a 24/7 touchpoint between the patient and prescription, make it easy to follow the prescribed therapy, and establish a positive relationship between the patient and the pharmacy. They can be used to manage transitional care, chronic disease, and aging-in-place patients. To date, they have been shown to be effective in reducing hospital Page | 16 DRAFT ::: Document1 admissions, in managing high-risk cancer and chronic disease populations, and in high-cost specialty pharmacy applications. Conclusion This concludes this demonstration of the Central and Facility Pharmacies within the intelligent hospital pavilion. You’ve just seen how the integration of many different technologies can enhance patient care and safety, optimize staff workflow, and assist in management of pharmacy inventory. Please visit the other rooms in the Intelligent Hospital™ and visit our sponsors in the Pavilion kiosks to learn more about these dynamic technologies. And for more information about any of the technologies you’ve seen, pick up a copy of the Intelligent Hospital Handbook. Thank you. Page | 17 DRAFT ::: Document1 Appendices A-Setup procedures for Next Tour 1. Put props back to original location 2. Reset movie to beginning B-Sample Labels to be Printed 1) Scan events – Track & Deliver a. Pharmacy b. Nursing Unit Page | 18 DRAFT ::: Document1 C. Map of Room (not to scale) 25 feet pwr Emerson long Wall fixture 74" wide Emerson short Wall fixture TPN Compounder & Hood Braun 50" wide 25.25"deep 25.25"deep Emerson short Wall fixture 73” W x 34” D x 49 ½” H Po Power: 110 V (computer) Talyst Workstation on table only 39"H x 28.5" W x 30.5"D Kitting & Compounding pwr Ou tpa Talyst to provide table Floor mounted 50" monitor #1 (knee height) pwr table for workstation next to Carousel Island – need to make this 39"H x 28.5" W x 30.5"D C D R r BO iste g re Em e rson l ong 74" w 25.2 Wall fix ide 5"de ep ture pwr ha rm ac y 48" wide 30"deep pwr OmnicellM5000 30 inches wide x 35 inches deep x 80 inches high and weighs 1000 pound Air compressor for m5000 tie nt P door 78"H x 82"W x 49.5"D Signage Sterile Compounding Room AutoCarousel Mini Talyst pwr Color Key AutoCool + H Talyst 79.5"H x 29.5W x 32.5 D Power: 115 VAC 7.5A 1Phase, 110V (computer) pwr Floor mounted 50" monitor #1 (knee height) V monitors Au toV a Pharmogist ics / Carefusion 10 Ihp equipment 12 ut 4 0 l VA 1.13 Ta Mi C, " l ni 12 H x 5 yst VD 2" (co C S W x 2 u m 9 p ute pply "D (A r) uto Va ult ), 1 Stand mounted 50" monitor #2 (head height) 20 feet 0 Vendor Equipment r: Inpatient Pharmacy we 25.25"deep pwr pwr pwr To the or à 50" wide Wall graphic overlay Page | 19 DRAFT ::: Document1 D-Furniture & Fixtures To Obtain 1. Outbox with meds for Carefusion Page | 20 DRAFT ::: Document1 E-Furniture & Props: i PROPS: Drugs (JJ); empty vials, Syringes, big, small, Supplies: Baggies, Counting tray?, Labels with barcodes, sharps container, Equipment (JJ) graphics / posters ii Props: Need outbox Bins, JJ to bring, and scan barcode on them iii Furniture: table needed for baxter fake hood to go on top of iv Graphic or Prop: compounding hood graphic on the wall of the Central Pharmacy, need area to hang TPN ingredients. PROPS: compounder, bar code scanner, tpn macro and micro ingredients v Props: hanging bags of macro ingredients, (lipids, d20, saline), and micro ingredients Page | 21