Automation and Standardization Take Center Stage in Health System’s Centralized IV Compounding Strategy

At the 2025 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting & Exhibition, Laura Mark, vice president of pharmacy at Allegheny General Hospital, and Arpit Mehta, director of pharmacy at Allegheny General Hospital, discussed their health system’s transition to a centralized, robotics-enabled IV compounding model. They explained that standardization across the network has strengthened operations, improved inventory management, and created consistent practices regardless of site size. Automation has also enhanced accuracy, reduced training time, and provided technicians and pharmacists with greater confidence and visibility into preparation quality. Both leaders emphasized that centralization supports workforce growth, frees staff for more patient-focused activities, and improves safety through measurable, uniform compounding practices.

Pharmacy Times: What was the strategic vision behind moving to a centralized, robotics-enabled IV compounding model, and how does it align with your broader pharmacy operations goals?

Laura Mark: Our intent was really from a standardization perspective across the network and making sure that our operations, inventory management system, IV preparation, and any type of operation were the same across the network. From standardization, it really gives visibility into all of our operations, and it makes sure that whether you're at the community site or at a large academic medical center, the same care and our processes are the same for all of our patients across the network.

Arpit Mehta: And I think, just to add to that, our vision at Ahn Highmark is freeing people to be their best. So leveraging automation where we can by standardization, removing variation, and standardizing practices allows us to supplement our operations and reduce expenses from fireside purchasing, specifically in the IV robotics world. And honestly, it gives us more control over our inventory. So when we have spikes in usage for certain medications—winter months, summer months—we can fluctuate and adjust to what we do. So there are significant benefits from that perspective, and truly centralizing is the way to go. If each site did their own thing, we wouldn't have the efficiency to do it that way. Laura has set that culture for Ahn as one team, and this is how we proceed. So that's our journey and thought process there.

Mark: I think some of the benefits that we've actually seen are the confidence that our technicians and our pharmacists have by having that automation to support them and that standardization. So even training a new technician—our time to train has significantly decreased because as long as they follow the prompts that the automation has for them, they’re in line with the practices.

Pharmacy Times: Since implementation, how have robotics impacted day-to-day accuracy, production throughput, and overall efficiency?

Mehta: I think dramatically. If you think about IV automation in general, what you don't measure, you don't know. So in the past, while we obviously trust our technicians and they do a great job, if we didn’t measure—which we didn’t without automation—you have no idea what's actually in that IV bag or what went to the patient because we don't directly observe every prep. With automation, we know exactly what volume of the medication, what literal amount, and every activity the technicians do in compounding the medication. We know exactly how it was prepared and the exact concentration it was made at the end of the day. That is a huge safety benefit that we just didn't realize before. We can capture errors or have visibility on potential errors that we just didn't have before. And honestly, Laura touched on this earlier—standardization is huge. No two technicians in the same clean room compound the same IV the same way. Multiply that across the network, and variability becomes significant. So standardizing that across the network to say, "This is how we prepare every medication in the same way, and this is how we measure safety and accuracy," is a tremendous improvement from before to now.

Pharmacy Times: How has the centralized model helped standardize processes and better support technicians and pharmacists across the health system?

Mehta: From my perspective—and Laura can certainly chime in—I think it allows for growth. It allows for not just our technicians and pharmacists but even residents. As they're training at our sites, they often go to other places after residency and will get back to us saying, “Oh my god, I’m missing the automation; I'm missing the tools I need to do my day-to-day job.” That’s the value it provides to our technicians and pharmacists. It makes them more marketable for their next position. It gives them the opportunity to grow, gives them data, gives them analytics, and gives them the support they need to do what they do best, which is providing direct patient care and not being bogged down by operational activities. There’s a lot of value in automation for efficiency. We’ve freed up our technicians to do more patient care activities that we just couldn't do before because of resource limitations.

Mark: By freeing up resources, we've been able to put them more in a meds-to-beds perspective, where they’re right there for the patient and providing direct patient care. The other piece is that it has really given them confidence because they get that feedback. Even when a pharmacist isn't always there, the automation gives them feedback that they're doing the correct processes. And that's confidence as well.