They are two of the Medical Center's fleet of nine TUGs — ROBOTS that navigate by wireless technology to deliver medications to patient units, often to the delight of visitors who encounter them in the corridor. UMMC became the first hospital in the world to use the Aethon TUGs to deliver medications in 2002, with more than 100 hospitals nationwide following suit since then. Now, UMMC is the first in the country to equip two of the TUGS with enough security and tracking technology to deliver medications that require more documentation than the robots previously could provide.
So far, only the two Shock Trauma Center TUGs have the new tracking technology, but early reviews from the nursing staff are favorable. "We plan to expand to the Weinberg and Gudelsky buildings if the data we collect for the pilot project in the Shock Trauma units is favorable," says Marc Summerfield, MS, director of pharmacy at UMMC. "So far, it has been."
The TUGs have a whimsical appeal – Mr. Gower is named for the pharmacist in the movie "It's a Wonderful Life," and Florence is named for Florence Nightingale – but they are all business. Their electronic "whiskers" can sense someone in their path, which brings them to a halt to say, "Waiting to proceed."
Hospitals must document and track some medications more thoroughly than others. So the TUGs give their precious cargo only to someone authorized with a PIN and, lest anyone's PIN get hijacked, a fingerprint that the built-in scanner recognizes.
Radiofrequency identification (RFID) technology allows the TUGs to read a tag on each dose. In this way, the TUG knows who withdraws what, and thus is responsible for each dose, and records a complete chain of custody. The TUGs transmit this information back to the pharmacy staff, who can track the whereabouts of any dose at any time and determine who has custody of the medication.
Playing off the way FedEx and other delivery services track their packages around the world, the TUGs manufacturer, Aethon, calls this new tracking system "MedEx."
The automatic documentation frees nurses and pharmacy staff from most of the cumbersome chain-of-custody paperwork otherwise required to comply with federal law, giving them more time that can be dedicated to direct patient care.
"The transfer of time from paperwork to patient care is an example of 'walking our talk,'" Summerfield says. "I think it's just safer," says Cynthia Cosgrove, RN, BSN, CCRN, a nurse in the R Adams Cowley Shock Trauma Center. "It's a more accurate way to have the medicine accounted for. Nothing is lost in translation. It means fewer interruptions for the nursing staff and makes patient safety the priority."
The RFID provides thorough documentation that eliminates some potential gaps in the paper-based system, says Meagan Rushe, PharmD, the pharmacy manager who coordinated the pilot program.
"We can track in real time exactly where a controlled substance is, which has never been possible with the paper forms," Rushe says. "And if the cart gets stuck somewhere, we can actually look through its eyes: Each cart has a camera, and the staff in the pharmacy can see through it on the computer. And it's greener – it saves a lot of paper."