In the new Stanford hospital, the human employees will be joined by a fleet of robots programmed to take on some repetitive and mechanical tasks.
November 4, 2019 - By Daphne Sashin
The more than 5,500 Stanford Health Care employees who work at the new Stanford Hospital will be joined by a fleet of robots programmed to deliver linens, packages and medical supplies, keep track of the hospital’s medication inventory and count out pills for nurses to administer.
The new hospital opens Nov. 17.
Handing off repetitive and mechanical tasks to machines — 23 delivery robots that will travel on pre-programmed routes throughout the hospital and three pharmacy robots that will store and package medication — will prevent employee injuries, reduce medication errors and free up staff to focus on the more valuable and satisfying work of assisting clinicians and caring for patients, said Gary Fritz, vice president and chief of applications for Stanford Health Care.
“The real value of pharmacists and pharmacy technicians comes when they use their clinical knowledge to care for patients, not to count pills,” Fritz said. “Similarly, in the supply chain, routine activities like pushing a cart 30 minutes in each direction isn’t really job enriching, but what is enriching is if those people can talk to patients or spend time figuring out how to get better supplies.”
Autonomous robots ‘TUG’ supplies
At 4 feet high, the TUGs will serve as autonomous couriers, hauling heavy loads of supplies between the central loading dock at 300 Pasteur Drive and the new hospital at 500 Pasteur Drive — a half-mile round-trip via tunnel. The TUGs move about 2 miles per hour and can pull more than half a ton.
“We’re automating the heavy movement across long distances to protect our employees,” said Shaheed Hickman, supply chain project manager at the hospital.
The robots use lasers and GPS to create a 3D map of their surroundings and determine if they need to stop or move to get around an obstacle. The robots convert that 3D map to a 2D image, so managers and staff can remotely track them in real-time. The TUGs have the capability to open doors wirelessly and stop when they sense movement that may interfere with their path. They can distinguish between stationary or moving obstructions within a 10-foot radius and alter their course accordingly.
While you can’t have a conversation with them, they do speak a few phrases — including “crossing hallway” and “TUG has arrived” — and they stop the moment they are touched. If a fire alarm goes off, the robots pull off to the side of the hallway to get out of the way.
Initially, the TUGs will be used to carry carts full of small packages, bulk food, nonurgent medical supplies and linens to the basement level of the new hospital, where, for now, a staff member will get the items to their final destination. The TUGs also will haul dirty linens, used food trays and garbage from the new hospital and ferry it back to the dock.
In between jobs, the TUGs automatically return to recharge at their docking stations.
You won’t see many pills in the new hospital pharmacy. That’s because most of them are stored inside three giant robotic machines, which don’t get tired, rushed or make mistakes as they’re filling drug orders for patients.
Two of them, the BoxPickers, aren’t what you imagine when you think of a robot. They are more like giant cabinets with a computer interface on the outside. Inside, there are stacks of drawers containing boxes of medications and a mechanical arm, or picker, that moves up and down the aisles. The BoxPickers currently store nearly $5 million worth of medications — about 80 percent of what’s stored in the patient care unit’s medication dispensing cabinets, located in the medication areas on the hospital floors.
Each day, when it’s time to restock the dispensers with medications, the technician checks the BoxPicker’s computer to determine which are needed and in what quantities. On the other side of the cabinet, the arm locates the box containing that specific medication and moves it into a drawer that unlocks for the technician.
Besides the time-savings afforded by the pharmacy robots, the machines reduce the chance of pill-selection errors, said Douglas Del Paggio, PharmD, assistant director of pharmacy.
“Instead of me going over to a bin and pulling a drug and looking at it — and if I’m in a rush, I may accidentally pull the wrong one, or the wrong drug is in the wrong bin — in these robots, it is all bar-code scanned and checked, so it’s very accurate — like 99.9 percent,” Del Paggio said.
The BoxPickers also keep a running inventory and automatically generate new orders for the drug wholesaler on a daily basis.
“You have more seamless control of inventory, because you’re not just eyeballing and saying, ‘I think I need more of that,’ which is how we’ve been doing it for decades,” Del Paggio said.
Across the room, a third robot — a suction-powered machine called the PillPick — counts out bulk medications and slides them into individual, bar-coded packets.
When a physician puts a patient’s order into the electronic health record system for one of these drugs, the only human work required is for a pharmacist to verify the order. Then the robot goes to work, whirring and hissing. Within seconds, a day’s worth of medicine slides down a conveyor belt, organized on a plastic ring.
The PillPick can package 1,000 doses per hour — the same amount that it would take a pharmacy technician about 10 hours to pack by hand.
“This allows our pharmacists and technicians to instead spend more of their time with physicians, nurses, and most importantly,” Del Paggio said, “directly with patients and family members.”
Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu.