If a healthcare institution makes a decision to deploy a point-of-use dispensing system for med/surg and other supplies, a choice needs to be made between the systems available from the three major vendors (Pyxis, Omnicell, and McKesson) The first choice is available between an "open" system and a "closed" system, or a combination of open and closed components, followed by a determination of which vendor's product should be chosen for installation. This nOPED attempts to (very) briefly bullet/list the various factors that should be considered in making this choice.

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The factors that need to be considered can be grouped as follows:

• Machine/System:    This category includes all the system characteristics from a hardware and software standpoint. These include the various cabinet configurations and modules, the software databases and interfaces, and the quality aspects of the hardware/software. Go here for an outline of machine factors that should be evaluated/considered.

• Information:    This category includes the queries and reports that are available, including several important characteristics of these such as delivery, etc. Go here for an outline of various information factors that should be evaluated/considered. Given that the transaction database will contain records of all items used by patients, a BI or data-mining capability that is robust and easy to use is an important attribute.

• Processes:    This category includes all the setups and daily processes involved with the point-of-use cabinets. Go here for an outline of process factors that should be evaluated/considered.

• Environment:    This category includes all "external" characteristics shown above, e.g. both internal and external (vendor) support and service - beyond the availability of 24/7 phone support, are there local support engineers available, what is the guaranteed response time, etc.

• People:    This category includes all the 'human factor' characteristics shown above, including training (both initial and ongoing), and ease of use. As mentioned in nOPED1 "Nurses play a critical part in ensuring the appropriate replenishment of the Omnisuppliers. If items are removed from or returned to the Omnisuppliers without the appropriate buttons being pushed then the system on-hand counts will be incorrect. This will result in inaccurate replenishment and consequent inadequate levels of stock. Ongoing nurse education and training is vital, both to inservice new staff and to reinforce correct utilization of the Omnisuppliers by current staff." Most of the advantages that will be gained by the use of point-of-use dispensing units can be lost with poor compliance, so ease of use and any features that promote compliance are very important.

• Financial:    This category includes the financial characteristics that need to be considered, including acquisition costs, installation costs, and ongoing costs.

• Misc:    Miscellaneous factors that might play into the comparison are shown above. These include potential cross-department synergies (e.g. using a system for both drug and med/surg dispensing), potential vendor synergies (e.g. using a point-of-use system from a vendor that also is a distributor, etc.), any relevant partnerships between the POU vendor and other vendors, etc. Also included here would be any setup/migration tools and assistance provided by the vendor.

• The Future:    "Future" factors include the characteristics shown above, including upgrade plans for hardware and software, other present and future technologies that might be integrated into the point-of-use system, and finally future integration with "bedside" technologies, etc.

The selection process should involve utilization of an inter-disciplinary team with members from Materials, Pharmacy, Information Services, and Nursing (to include both front-line nurses and nursing managers), which will look at, try, and evaluate the different systems considering all the factors outlined. In general one is likely to find that there will not be a clear "winner" between the major vendors in terms of the different equipment and their capabilities. Even though there will be differences in configurations, systems, and setups, overall the products of each vendor will provide all the necessary functions e.g. inventory control, charging, etc. The future evolution of the various systems also appears to proceeding along similar lines. Thus the decision comes down mainly to the human factors (user preferences) and the financial considerations, with consideration also being given to the miscellaneous factors above.

© SNi - 06/21/2003