Sentara RMH Medical Center achieves 99% drug distribution efficiency with XR2 system

Sentara RMH Medical Center moves further toward the Autonomous Pharmacy with the XR2 Automated Central Pharmacy System, which is enabling them to automate nearly all of their central pharmacy dispensing activities.

The Challenge

Sentara RMH Medical Center is a 238-bed community hospital providing cardiac, oncology, orthopedic, and mother-baby service lines, among others. It serves a seven-county area in the Shenandoah Valley region of Virginia and is part of Sentara Healthcare, an integrated healthcare system with 12 hospitals in Virginia and North Carolina.

For nearly two decades, Sentara used the Omnicell® ROBOT-Rx® Central Pharmacy Robotic System to automate medication distribution and enable top-of-license practice. Through the years, the pharmacy team became skilled at optimizing the system for peak efficiency and capacity, particularly as prescribing patterns and patient mix changed. However, as the system reached its upper limits, the team sought new options. 
 
Pharmacy was joined by IT to develop a five-year strategic plan, including a comprehensive assessment of medication distribution models and supporting technology. The objectives included:
 
  • Maximize pharmacist clinical time 
  • Support nursing’s patient care model
  • Reduce manual processes 
  • Lower inventory costs and maximize inventory turns
  • Reduce reliance on medication unit-dose packaging

Sentara RMH Medical Center is a 238-bed community hospital providing cardiac, oncology, orthopedic, and mother-baby service lines, among others. It serves a seven-county area in the Shenandoah Valley region of Virginia and is part of Sentara Healthcare, an integrated healthcare system with 12 hospitals in Virginia and North Carolina.

For nearly two decades, Sentara used the Omnicell® ROBOT-Rx® Central Pharmacy Robotic System to automate medication distribution and enable top-of-license practice. Through the years, the pharmacy team became skilled at optimizing the system for peak efficiency and capacity, particularly as prescribing patterns and patient mix changed. However, as the system reached its upper limits, the team sought new options. 
 
Pharmacy was joined by IT to develop a five-year strategic plan, including a comprehensive assessment of medication distribution models and supporting technology. The objectives included:
 
  • Maximize pharmacist clinical time 
  • Support nursing’s patient care model
  • Reduce manual processes 
  • Lower inventory costs and maximize inventory turns
  • Reduce reliance on medication unit-dose packaging

The Solution

 
After a thorough review of available options, Sentara’s pharmacy leaders chose Omnicell’s XR2 Automated Central Pharmacy System. The XR2 system automates medication storage and retrieval to increase medication safety, improve operational efficiency, and maximize inventory control. 
 
The XR2 system provides:
 
  • 100 percent barcode scanning, eliminating human error
  • Support for cartless and cart fill distribution
  • Advanced algorithms to reduce waste and maintain accurate inventory 
The system leverages manufacturer barcodes, making unit-dose packaging unnecessary, and supports more than 90 percent of non-IV and non-narcotic formulary in a variety of form factors, including individual blisters, blister cards, vials, cups, packets, syringes, and others. 
 
Realizing Transformational Outcomes  

The XR2 system automates nearly 99% of cart fill and first dose medications dispensed at Sentara RMH and enhances the hospital’s preferred distribution model.

Overall, approximately 75% of patient medications are distributed via the XR2 system and delivered to locked nurse servers located within patient rooms. Other medications, such as PRNs and narcotics, are stored in unit-based automated medication dispensing cabinets.

In performing the daily cart fill, the XR2 system pulls orders from the Epic system. The XR2 system knows which medications are stored in its inventory and automates dispensing of approximately 2,500 patient-specific doses. Another 500 first doses are similarly automated through the XR2 system.

This high level of automation efficiency enables Sentara RMH to transfer pharmacist and technician labor from distributive to top-of-license functions. Staff are no longer required to complete complex repackaging operations, and with the expansion of products dispensed through the XR2, it has decreased the time spent manually picking medications.

Explained Jamin Engel, Interim Director of Pharmacy, “Not only is the XR2 system safer and more dependable, but it allows staff to function outside of supporting robot technology. The unexpected gains are supporting a more efficient operation. Pharmacists are now checking less than 50 manual picks a day, a 90% reduction, through a safer technology-driven distribution process.”

In fact, according to a recent study, while most health-system pharmacies spend approximately 20% of their time on distributive tasks, Sentara RMH pharmacists reduced their distributive burden to less than 5%. 

xr2 machine

Optimizing Inventory with Real-Time Data

The XR2 system also automates restocking and inventory management, providing further benefits to Sentara RMH.

The pharmacy shifted from purchasing bulk medications to manufacturer unit-dose packaging forms. The cost difference was negligible and offset by eliminating consumable costs and reallocating packaging labor.

“About 85% of all product we order now is in unit-dose blister package form with 2D stacked barcodes,” said Engel. “Using manufacturer packaging is inherently safer and it’s more efficient because the need for a pharmacist check of repackaged medications is eliminated.”

Further, Sentara RMH increased its automated storage inventory by 80%—to 45,000 doses—and increased automated line items to 750. The team uses the XR2 system’s inventory logic, which dispenses earliest-to-expire medications first, to reduce waste. At the same time, the pharmacy increased its inventory turns to 16, by the dynamic inventory management system offered within the XR2.

“Our goal is to have 100% of medications leaving pharmacy to be verified for accuracy by being scanned using barcode technology,” said Engel. “The XR2 system significantly improves our ability to deliver on that goal.”

The Impact

Key Outcomes:

  • Achieved automated dispensing to 99%
  • Reduced medication packaging by 90%
  • Reduced pharmacist checking by 90%
  • Reduced pharmacist distributive tasking to 5%

Customer Benefits: 

  • Improved automation capacity by 80%
  • Reduced repacking costs
  • Increased inventory turns to 16

KPIs Impacted: 

  • Improved patient safety
  • Increased efficiency
  • Lowered costs

"The more we move away from manual picking and verification of medications, the safer and more efficient our processes will be."

Jamin Engel, Interim Director of Pharmacy

omnicell closing icon