1
Q
Why make things more automated?
A
Keeps to regulations
Cost saving
Keeping the patient happy- fewer shortages, dispensing errors e.g. wrong dose/drug
Better quality care
Saves time
More robust results e.g. in formulation, drug discovery, diagnostics
2
Q
What are the 5 things you have to think about in terms of robots?
A
- Components
- What kind of system is it?
- What type is it? (application)
- What will be its suppliers e.g. hospital, community pharmacy
- What are the principles? Any potential failures or safety issues?
3
Q
The classical robots were made if it satisfied the 3 Ds. What are they?
A
Dull = repetitive, which is error prone and high cost of error
Dangerous = materials that could be dangerous to humans
Dirty- contamination, jobs that humans do not want to do
4
Q
How do the 3 Ds apply to pharmacy?
A
Dull= repetitive dispensing process
Dangerous= toxic drugs
Dirty = you can contaminate medicines and they can contaminate you
5
Q
Why do you need safety systems for a robot?
A
It a robot is doing its own thing, you need to ensure safety
Incident logs
Accidents do happen and there are failures in the system. People have died whilst using robots (there is an industrial robotics and medical robotics database to report these fatalities)
There is a legal and ethical duty of care
Hacking attacks and privacy
Importance of training and awareness
6
Q
What are the 3 core elements of a robot?
A
- Sensors e.g. cameras, microphones, proximity sensors
- Controller- Processor, memory, instructions, data, history
- Actuators - Motors, wheels, arms, grips, communications
Powered e.g. by a battery for autonomy
There may be a cloud for data
7
Q
Who are the users and who are the customers?
A
User- operator, supervisor
Customer- patient, clinical staff, nurse
8
Q
What is the difference between a structured and unstructured environment?
Which environment are they designed to work better in?
A
Structured = closed e.g. in a factory
- Clear goals
- Authorised, trained staff
- No waste or clutter ideally
Unstructured = open e.g. at home
- No clear goals
- Different people
- Clutter
Robots are designed to work better in structured environments
9
Q
What are the 3 dimensions for robotics?
A
- Interaction with people
- Autonomy - how self aware it is to do its own thing
- Mobility - how free moving is it?
10
Q
What is a teleoperative robot?
A
Humans control the robot. It is not free to make decisions
11
Q
What is a shared workspace?
A
Higher level of interaction between humans and robots where they work together and alongside each other
12
Q
What is a co-existance interaction?
A
Robot is aware of human being present. There is no contact
13
Q
What are the 4 types of interaction?
A
- No interaction
- Coexistence
- Cooperation
- Collaboration
14
Q
What is a disadvantage of humans working close with robots?
A
Limitation of performance- the robot is restricted by speed and power
15
Q
What is the paro seal robot?
A
To comfort those with AD
Has voice recognition and a light sensor
Can move so has actuators in eyelids, neck and fins
16
Q
What are the 9 main elements of a robot?
A
- Motors, wheels, arms to grip objects
- Sensor, camera
- Communications, wifi between robots
- Interface user, screen, light, sound
- Memory with instructions, history
- Controller
- Power, battery, limited life
- Data and measurement capability
- Service provider-won’t see this in the robot
17
Q
Who is a stakeholder?
A
- Interest in the system
- Has the ability to stop the use of the system
- User/operator/technician/manager/staff/patient
- Could even be hackers
18
Q
What does QBD and DOE stand for?
A
Quality by design
Design of experiment
19
Q
What is the difference between narrow and broad scope?
A
Narrow- robotics to support pharmacy
Broad- robotics to support healthcare
20
Q
Pharmacy is the 3rd largest component in health systems but has the most opportunity for cost reduction. True or false?
A
True
21
Q
What is the advantage if the MMIP roadmap?
A
Helps manufacturing to identify projects and needs.
Flexible planning technique to support strategic and long-range planning
Just gives advice
Looks at priorities for the company
22
Q
Name the role of robotics in developing new treatments
A
- cell therapy and biologics e.g. cell culture ambr (rapid automated microscale bioreactor system to replicate classic lab-scale bioreactors)
- 3D printing and testing
23
Q
What are some applications in robotics in Pharmacy?
A
- Medication dispensing system e.g. robot
- Bar coded medication systems
- Bar coded unit dose packaging systems
- Automated drug storage and retrieval
- IV compounding robots
- Smart pumps
- Distinguishing between expired products
24
Q
What are disadvantages of drones?
A
Cost Control Loss Accident E.g. if it is carrying blood samples- what if it crashes? Security – breaking into the drones
25
What are the two main drivers for getting a robot?
To reduce time and cost long term
26
How come a company usually buys 2 robots?
Just in case one breaks down. It is a higher cost but overall a safer bet
27
What is the cell culture ambr?
* Rapid automated microscale bioreactor system to replicate classic lab-scale bioreactors
* Can use more vessels and replicate more
* Compared to using bioreactors which requires more staff, longer days to set up
* Bioreactors = system that can grow cells/tissues, for use in tissue and biochemical engineering
* Instead of a glass container, you have tiny plastic containers with its own stirrer and bioreactors - when you put it in the robot, the robot can move along and add/remove media from the cells and take measurements - considerable level of autonomy as it can work within a certain space
* Sterile and individually wrapped with a pH and DO (dissolved oxygen) sensor and impeller inside
* Manual way was a lot of work. This is quick to set up
* Temperature and pH can be controlled by the robot via sensors
28
What are the benefits of robots?
- Quality, costs, tracking
- Uptime and utilisation- how long it will be running for and how much will you use it
- Compared to staff- don't get ill/go on strike/go on holiday
- Return on investment
29
What are the disadvantages of robots and what is missing?
- Interfaces to other systems
- Informatics and analytics
- Integration with 3rd party systems
- Viruses
- Does need time to upgrade so goes to sleep
- Needs to keep moving to keep axis working
30
What is uptime?
Measure of the time a machine has been working and available, often used as a measure of time that it can be left unattended without crashing/needing to be rebooted
31
What do the following stand for:
CMA
CPPs
Critical material attributes - input
Critical process parameters- operation
Critical quality attributes - output quality
32
Robots can automate formulation optimisation - what is formulation optimisation?
* You have different parameters and different values within these parameters
* Many different combinations
* Multi-factorial experiments
* E.g. 4 different values for each parameter
Using a small set of critical process parameters and select values
Design space is made e.g. contour plots
33
What are the types of logistics in hospital?
1. Goods- Medical and non-medical goods logistics
| 2. Persons- Visitors, patient and employee logistics
34
What are the 5 steps of a lifecycle of a product?
1. System selection- scope, requirements specification, audiences
2. Installation and commissioning
3. Operation
4. Maintain - repair, IT back up
5. End of life- upgrade, repurpose (e.g. can a smaller hospital use it?), replace, recycle
35
What 3 things do you need to consider when system selecting?
1. The scope- general statement of purpose, especially important when communicating with people higher up in the company (managers) so they know what they are going to get
2. The requirements- a list of needs from the stakeholder
3. The specification- detailed document for the supplier
36
Stakeholders tend to have connections between them. True or false?
True
37
When making a decision, what are the options?
- General consensus
- Vote
- Power vote
How do you prioritise these decisions>
38
What is a workflow map?
Lots of different projects and tasks (logistics, interaction). Behind each different task, there will be different stakeholders and specification documents.
Distinguishes the what from the how- are they achievable?
39
What 5 pieces of information do you need for each system for a specification document and why?
1. Name/Unique ID - identification
2. Short description- e.g. “the system responds in 3 seconds” to know how good it is. Can define what the system is in a specific numerical format – it is no good saying “will respond quickly” because different views on what is quick
3. Priority - How important it is (low, medium, high). It could be essential – not negotiable
4. Reference - Where it came from- which interviewer, which stakeholder, what date to avoid any ambiguity and to be able to go back to that person and have evidence
5. Be testable - so you can check it has been met
40
What is the structure of the specification document?
* Need the 5 pieces of information
* Functional requirements (what is does) vs constraint requirements (what It has, what country/environment it will operate in, certification)
* Version control and date
* Author name and role
* Review and sign-off by the stakeholders (agreement/consent)
41
What happens if specification requirements are not clear?
Things get lost in translation – within the healthcare community, lots of different acronyms for different things
42
What is the difference between verification and validation?
Verification- do the thing right
Validation- do the right thing
43
What is a traceability matrix?
Table with design elements vs requirements
* Match the design and tests to the requirements
* Big table with the lists of requirements and design elements
* Checks every requirement has a test and that every test is useful
* Focus on the main new features
44
If you were a company looking for a new robotic system, what would you do (Tendering process)?
1. Submit an RFI- request for information, where you ask the market/industry (suppliers) on a particular website and they will provide you info on what they have. Sometimes, they may just provide a catalogue so they come to you trying to get your business.
2. RPI- Request for proposal – the hospital/government asks a select few suppliers to send them a proposal, so they get further information
3. RFQ- Request for quotation- narrow down to a couple of companies (at least 3) to get quotes. You need to be careful if it is too cheap however as it may not include all the components that you want.
45
What is the difference between hard and soft factors of an organisation?
Soft Factors of the organization are those elements that are difficult to design and define a defacto exist due to the presence of people in the organisation
The hard factors are those which influence business practices in a direct and fundamental way. They are seen as facts, hard, real, unavoidable. One can identify, collect and measure them
46
What is a cost centre within a business?
* Provides support for organisation
* Development is funded centrally per year
* Supports one off investments e.g. new equipment, and also ongoing salaries
* The department has a set of assets
* Poor understanding of costs as it just gives the money out
* Disconnected from overall operations
* Defends its budget (negative view)
47
Cost centres have now shifted towards another type of service. What is this?
Profit centre
* Much more of a service
* Charges customers for a fee for the service, which this income paying for investment and salaries
* Department calculates the return on investment à can reinvest in new assets (positive view)
* This has a better understanding of costs, savings, time and effort
* Service price and quality negotiated and agreed
48
What is CAPEX?
Capital expenditure
Investment in system
49
What is OPEX?
Operational expenditure
-Ongoing cost for running the system (staff, service costs)
50
What is the benefit of doing a cost benefit analysis?
Saves staff headcount
Saves time - you can do more with same staff
Reduce waste of stock
Reduced errors
Patient quality of care
51
What is a soft factor in terms of a robot?
Public perception and acceptance
* People may be suspicious of them e.g. what they have seen in films etc.
* May respect it, especially if it looks human-like e.g. have eyes, eyebrows
* People may not like it
* People may name the robots
52
What else can be done with public perception of robots?
* Awareness- open days and visits with the public
* Training courses
* Playing with robots
* Support- having a contact person e.g. in Denmark, there is a chief robotic officer
* Incentives- joint rewards
53
What is the organisation process LEAN?
* Reducing waste
* Improving quality
* Focus on the essentials
* Understanding what you can do and how you can do it better e.g. if the staff are having to move around a lot to get different things they need to work, could organise the work space more so these things are closer to them. Systematic way.
54
What does the LEAN: 5 s methodology stand for?
1. Sort
2. Set in order
3. Shine
4. Standardise
5. Sustain
55
What 2 ways can you make robots safer?
1. Speed control
| 2. Sensors to reduce damage e.g. proximity
56
What are the advantages of robots?
* Bigger market
* Reduces repetitive injuries
* Quicker turnaround time
* Reduces cost e.g. labour
* Eliminates human error e.g. pipetting
* Humans can spend more time doing research and designing experiments than doing repetitive experiments
57
What can be done to counteract the following potential problems:
1. Data privacy
2. Hacking
3. Attack, error, fraud
4. Spoofing, DDOS (distributed denial of service attack)
5. Cyber attack
6. Ransomware
1. Data privacy - data encryption
2. Hacking- Passwords
3. Attack, error, fraud- Audit, regulation, training
4. Spoofing, DDOS (distributed denial of service attack)- Biometrics (measurement of human characteristics)
5. Cyber attack - Patient, staff
6. Ransomware- Update, back up and recovery
58
What is metric?
Meaningful measure as a basis to make decisions
To decide, improve and design
Decisions are made based on objectives pre set
59
What is a good metric (EROR)?
Easy (cost effective) to measure: not absorb effect e.g. time
Relevant: contribute to decision making e.g. patient care
Objective: not open to interpretation e.g. spend a lot of time with the stakeholders so everyone is on the same page
Robust: same result every time
60
What would be the metrics that you would need to consider for robotic systems in healthcare?
1. Dispensing errors - hard
2. Turnover rate of prescriptions - hard
3. Money and time - hard
4. Staff satisfaction - soft
5. Patient quality of care - soft
The robotics company would work with the stakeholders to prioritise these metrics and see which ones are the most important for them. There are no definitive lists but there are bad choices
61
What is a pro and con of using single metrics?
Easy (cost effective) to measure: not absorb effect e.g. time
Relevant: contribute to decision making e.g. patient care
Objective: not open to interpretation e.g. spend a lot of time with the stakeholders so everyone is on the same page
Robust: same result every time
62
What are the 5 rights from pharmaceutical industry?
Right patient, right drug, right dose, right route, right time
63
What is the process to follow with metrics?
1. List your stakeholders (patient, staff, organisation)
2. Identify their motivation and drivers for each
3. The 5 rights from pharmaceutical industry – right patient, right drug, right dose, right route, right time
4. Quantitative/qualitative?
5. Design appropriate metrics
64
What is the current problem with metric studies?
Current pilots are too small and unsystematic. You need longer-term, well designed before and after studies with large number of users.
65
What does FTE stand for?
Full time equivalent - one person's salary
66
Sensitivity analysis- what could go wrong with the supplier and your expenditure into these systems?
at happens if:
* There is a change in the exchange rate?
* The supplier closes down?
* The supplier company is acquired and stops support?
* Unknowns- holidays and sickness
* Additional costs not in original plans e.g. installation plans, what if the floor is not strong enough?
* Change in regulations
* Reliability – look at the contract, indication of confidence or risk
67
What are the problems and alternatives to consider when choosing a robotic system?
* Need funding - Leases can help spread out costs
* Outsource- how will the robotics company know what’s right for your situation?
* Or you don’t have to buy the machine, and keep to existing practices
ETMM
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Decks in class (5)
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