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Right drug, right dose, right time, right patient!

With medication error rates anywhere between 5% and 40%, eliminating human intervention from the process of medication distribution could dramatically reduce the number of errors occurring, some of which can be serious or even life-threatening


HD Medi


With medication error rates anywhere between 5% and 40%, eliminating human intervention from the process of medication distribution could dramatically reduce the number of errors occurring, some of which can be serious or even life-threatening


HD Medi


In any facility where medication is prepared for patients, one of the most important factors to consider is medication safety. Many patients in hospitals or care homes need to take numerous drugs at specific times of the day. Due to the inherent complexity of ensuring that multiple medications are given to patients at the right time and in the right dose, inevitably problems can occur during preparation of drug regimens. When these regimens are prepared and delivered manually, there is a high risk of human error occurring. Whilst not every medication error will result in severe consequences, there are instances when a patient’s health could be badly affected, either through missing an important dose of a drug or by taking the wrong medication. As most errors are human, it is clear that automation is the future for the preparation of multi-dose medication.

Although many suppliers have entered the European market providing systems that make this process safer and more efficient, not all offer the same level of security, accuracy and cost effectiveness. Netherlands-based HD Medi and JVM, the global market leader for pouch packaging solutions bring together all their experience to overcome the technological challenges of automating pharmaceutical processes and the provision of medicines. HD Medi offers fully automated, patient specific dose-packaging systems, which produce pre-packed rolls of clear, individually sealed pouches for single, combi- and multi-dose medication. The automated packaging machines can hold between 30 to 500 canisters of medication and can produce up to 3600 medicine rations per hour, the equivalent of an automated medication supply for approximately 1000 beds each day. To cater for a smaller patient base, the HD Medi DEN system is also available without canisters to produce pouches for specific goals through a tray solution.

Every HD Medi system has been designed to be compatible with all commonly used hospital and pharmacy information, patient management, warehousing and accounting systems and feature an automatic cassette recognition system (ACRS-II) to save time when switching between medicines. Furthermore, they offer photo-optic and fully automated checking of pouches against the patient’s prescription plus a reporting function. The machines sort, pack and label the daily rations automatically, producing airtight, hygienic strips of pouches that can be easily distributed to patients. As every pouch has a unique barcode, pouches can be easily checked for completeness and compliance with the prescription.

Already an established player in community pharmacy in Europe, HD Medi is now targeting the hospital market. Demand in Europe is strong as many patients currently receive their medication in an outdated form of monitored dosage system that uses cardboard containers with four boxes on each day of the week or even standard original packs. Pouch medication from HD Medi offers much more flexibility and has more track-and-trace capability.

A member of pharmacy staff at the Wilhelmina Ziekenhuis in Assen, the Netherlands comments: “We have always prepared medication for patients manually, so there is inevitably an element of human error. Automated technology has allowed us to eliminate that so that we can offer greater accuracy and also offer more flexibility, as some patients need up to 10 medication administrations each day.”

A cost efficient capital investment
Whilst it may be easy to demonstrate the improvement in safety, security and accuracy that HD Medi’s systems offer, a crucial question for the healthcare sector where budgets are often tight, is whether the transition to a new automated system can be cost effective? This can also be easily proven as studies have shown that this technology is more economical than manual preparation or blister cards. For example, medications that are manually prepared from original packs to cups during a night shift can not only be liable to mistakes but also take up a lot of staff time. With an automated system it takes just a couple of seconds to prepare the next day’s medication for one patient. “There are huge savings to be made in terms of labour costs”, continues Wilhelmina Ziekenhuis, “and although there is an initial capital expenditure, an HD Medi system can give a return on investment within just one or two years.

Sales Manager for HD Medi, Elena Fernandez, explains: “If a hospital has 2000 patients, it would normally take 13 or 14 full time staff to prepare all the medication. By installing just one of our automated systems, this could be reduced to as little as three or four people.” As the company works to refine its technology even more, HD Medi are confident that further efficiencies will be achievable in the future. Because of these technological advances, HD Medi recommend that customers renew their automated systems around every seven years.

Elena continues: “Our aim is to automate the whole process of medication preparation, so we are looking at software for barcode screening to check the accuracy of medication delivery. This will improve security, safety and efficiency. Our equipment also offers better control of potential cross contamination than competing systems. It is relatively easy to clean all metal surfaces within the machines, so that any residue left by medication as it passes from the cassette to the pouches can be easily removed.

As well as offering state of the art systems, another of HD Medi’s key differentiators is their emphasis on after sales service and support. This is very important to customers who rely on the automation to produce patient medication and therefore local support is vital, which is why HD Medi always make sure to have a team of people on the ground, close to their customers.

Ward cabinets
If a hospital pharmacist is confident that they have produced error free medication pouches, bedside scanning of the barcode on the pouches can be introduced and the pharmacist could rely on the ward staff to gather all the other patient medication at the same time as the oral solid doses on the ward. But with nursing staff under pressure in terms of time, costs and responsibility, more and more pharmacy staff are playing a bigger role at medication administration times. In some hospitals, the pharmacy staff have even taken over the administration of bedside medication.

Another major tool, which could help to reduce errors and risks further on the wards, are ward cabinets. For a long time, ward cabinets have been “a thing for the US”, but not any more. A new product in this area is the INTIPharm, which offers significant advantages for hospital staff. It combines many of the functionalities that were already available from other suppliers but with a smart cassette system called Autobox which makes it possible to unit dose deliver syringes, vials and ampoules in a controlled way. It is even possible to refill Autoboxes in the central hospital pharmacy and lock them so that nobody can touch the items until dispensed to a biometrically identified nurse who can gather all the necessary medication for a patient at one station, the INTIPharm.

There can be no doubt that automation is the future of multi-dose medication, and as HD Medi take its products on the road to showcase them, hospitals and care homes throughout Europe should consider investing in an automated system that offers better performance, accuracy and major cost benefits in the long term.

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