Automation governs medication-dispensing systems in many health systems, enhancing safety and efficiency—as long as the computers that operate the systems don't crash. A growing trend in automation aggressively addresses this problem by allowing vendors to remotely monitor automation computer servers in real time, preventing crashes before pharmacists even know there's a problem.

"This makes sense for everyone to do," said Greg Hart, director of technical product management for McKesson Corp. in San Francisco, a major manufacturer of automated medication-dispensing systems. His company provides remote monitoring through an in-house product called Automatic Data Collection.

McKesson's competitors agree. "The basic idea is for us to know when a server is in trouble, fix the problem remotely, and go on-site only to make sure the problem doesn't get worse," said Michael Cline, VP for service at Omnicell Inc. in Mountain View, Calif.

Omnicell recently completed a pilot study of vDirector at eight hospitals and is rolling out the product to all its customers. In two of the eight facilities, Cline said, "critical errors involving faulty data backup processes were uncovered and immediately corrected." The company has set a goal of installing vDirector with 20% of its customer base by the end of the year. "Crashes are very annoying if they happen," said Lyle Koehn, R.Ph., leader of pharmacy operations at the Via Christi Regional Medical Center in Wichita, Kan. His hospitals have been Omnicell clients for six years and served as a vDirector test site. "The vDirector is an improvement over the old way, which was if you have a problem, you call the Omnicell help desk."

Soon after its recent installation, vDirector told Via Christi that its cabinets' main computer server was operating at a dangerously high percentage of capacity. "We were closer to a possible crash than we knew. It was valuable information. We needed a bigger system, so we upgraded," said Koehn.

Cardinal Health, manufacturer of Pyxis automated dispensing cabinets, also offers remote monitoring. Cardinal recently signed a licensing agreement with Axeda Systems, Mansfield, Mass., to provide what Axeda calls "device-relationship management" software to remotely support its cabinets. The Axeda DRM software permits real-time remote monitoring and service and can deliver software upgrades and patches, said Rob Sobie, Cardinal's VP for marketing, security, and services products.

"We chose the Axeda software for its overall system performance," said Sobie. "If any single component of the Pyxis system is overloaded or threatened with crashing, DRM notifies us and often fixes the problem instantly."

Omnicell's Cline said his company offers services as complete as Axeda's DRM software. The vDirector monitoring product is part of any standard automation contract. The automatic upgrades and patches are associated with Omnicell vSuite, however, which includes vCommander and vManager software monitoring and security software products as well as vDirector, and is sold separately. Cardinal also charges for upgrades to its Pyxis system.

McKesson's ADC service has been on-line for several years, said Hart. It is designed to fix problems at the customer's site and not just report the problem. The product monitors operating systems, database server, application server, and the system's network, functioning as a remote administrator. Most clients use e-mail transport for data transmission to McKesson; a few use a Web service and/or an FTP site. Web or FTP service is preferable, say officials of all three companies, because they offer two-way communication and delivery confirmation; the new Omnicell and Cardinal products are primarily Internet-based.