PillStream: Agile High-Throughput Assembly of Custom Multi-Medication Packaging

PillStream：定制多种药物包装的敏捷高通量组装

• 批准号: 8743825
• 负责人: Edward Acworth
• 金额: $ 39.93万
• 依托单位: MOSAIC LOFT
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-27 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8743825
• 关键词: Applications Grants; Beds; Bulla; Capital; Capital Financing; Cessation of life; Color; Computer software; Custom; Development; Discipline of Nursing; Dose; Drug Packaging; Drug Prescriptions; Engineering; Floor; Funding; Gelatin; Generations; Goals; Healthcare Systems; Hour; Industry; Letters; Long-Term Care; Manuals; Measurable; Medication Errors; Methods; Modeling; Nursing Homes; Nursing Staff; Oral; Patients; Performance; Persons; Pharmaceutical Preparations; Pharmacy facility; Phase; Production; Regulation; Request for Applications; Risk; Robot; Robotics; Safety; Services; Site; Skilled Nursing Facilities; Small Business Innovation Research Grant; Solid; Solutions; Sorting - Cell Movement; Source; Speed; Stream; System; Technology; Testing; Time; United States Centers for Medicare and Medicaid Services; capsule; commercialization; cost; design; dosage; flexibility; meetings; novel; pill; prototype; public health relevance; success; wasting

DESCRIPTION (provided by applicant): Errors in the administration of medications to residents of long-term care facilities (LTCFs) threaten resident safety and add significant unnecessary costs to the healthcare system. Use of unit dose medications that require LTCF staff to manually sort and assemble specific patient medications ~4 times per day can result in error rates as high as 42%, with 7% of total errors having significant potential for harm. Just preparing medications for administration consumes an estimated 6-8 person hours/day in a typical 100 resident LTCF, or an estimated 16,000 full time equivalents in all US LTCFs, reducing staff time available for other functions. Another unnecessary cost, estimated at $5 billion in US nursing homes alone, arises from medications that are wasted due to prescription changes and patient turnover. New regulations from the Centers for Medicare and Medicaid Services, effective 1 January 2013, target reduced medication waste by requiring "short cycle" fills (d14 days) instead of the traditional 30 day "bingo cards". However, even if this has the desired result of reducing prescription drug waste, industry sources predict that use of shorter cycle bingo cards may increase LTCF staff time and possibly errors associated with additional manual sorting of more unit dose packages. Proposed Solution. Artaic's novel PillStreamTM system incorporates proven advanced agile manufacturing technology, utilized in our successful TileJet robot developed for high speed low-cost mosaic just-in-time manufacturing. PillStream is designed for high accuracy, high throughput production of Custom Multi-medication Packages (CMPTM) that will enable Central-Fill pharmacies to provide their LTCF customers with short cycle dispensing at reduced cost and with closed-loop capability enabling return of unused medications. In SBIR Phase I we created a PillStream prototype that exceeded our primary success criterion of e99.9% placement accuracy for surrogate pills and gelatin capsules while exceeding our target fill rate (100 blisters/min) by 50%. Specific Aims. In this 24-month Phase II SBIR we propose to: 1) build and test a larger fully functional Pill- Stream prototype able to dispense up to 48 "fast mover" pills/capsules directly from wholesale medication bottles; 2) modify the onboard PS48 software to enable integration with pharmacy management software; and 3) beta test the PS48 in up to 2 Central-Fill pharmacies, using it to fill daily patient-specifc CMPs containing "fast mover" medications in order to compare accuracy and cost to existing methods. Success in meeting our target SBIR Phase II engineering specifications for accuracy (e99.99%) and throughput (e100 blisters/min and e10 daily CMPs/minute) in a real Central-Fill pharmacy setting should enable Artaic to raise Phase III funds for commercial production of PS48 and larger PS100 and PS200 units.

描述（由申请人提供）：长期护理机构（LTCF）的居民用药错误威胁居民安全，并为医疗保健系统增加了大量不必要的成本。使用单位剂量药物需要LTCF工作人员每天手动分类和组装特定患者药物约4次，这可能导致错误率高达42%，其中7%的错误具有显著的潜在伤害。在一个典型的100名居民LTCF中，仅准备给药药物就消耗了估计6-8个工时/天，或者在所有美国LTCF中估计消耗了16，000个全职等效工时，减少了可用于其他功能的工作人员时间。另一个不必要的成本，估计仅在美国养老院就有50亿美元，来自由于处方变更和患者周转而浪费的药物。医疗保险和医疗补助服务中心的新规定于2013年1月1日生效，旨在通过要求“短周期”填充（d14天）而不是传统的30天“宾果卡”来减少药物浪费。然而，即使这具有减少处方药浪费的预期结果，行业消息来源预测，使用较短周期的宾果卡可能会增加LTCF工作人员的时间，并可能增加与更多单位剂量包装的额外手动分拣相关的错误。建议的解决方案。Artaic的新型PillStreamTM系统结合了成熟的先进敏捷制造技术，用于我们成功开发的TileJet机器人，用于高速低成本的马赛克即时制造。PillStream专为高精度、高吞吐量的定制多药物包装（CMPTM）生产而设计，这将使中央填充药店能够以更低的成本为LTCF客户提供短周期配药，并具有闭环功能，可以退回未使用的药物。在SBIR第I阶段，我们创建了一个PillStream原型，该原型超过了我们的主要成功标准，即替代药丸和明胶胶囊的放置准确度为99.9%，同时超过了我们的目标填充率（100个泡罩/分钟）50%。具体目标。在这个为期24个月的第二阶段SBIR中，我们建议：1）构建和测试一个更大的功能齐全的Pill-Stream原型，能够直接从批发药瓶中分配多达48个“快速移动”药丸/胶囊; 2）修改板载PS48软件，以实现与药房管理软件的集成;以及3）在最多2个中心填充药房中测试PS48，使用其填充包含“快速移动”药物的每日患者特异性CMP，以便与现有方法比较准确性和成本。在真实的中心填充药房环境中，成功满足我们目标SBIR第II阶段工程质量标准的准确度（e99.99%）和通量（e100泡罩/分钟和e10每日CMP/分钟），应使Artaic能够为PS48和更大的PS100和PS200装置的商业生产筹集第III阶段资金。