By Rakhi Garg
Senior Product Manager
BD

 
As a Senior Product Manager at BD, I was recently involved in the development of a new product, BD Pyxis™ ES Refrigerator with Helmer Access Technology. This novel product can transform the way customers manage their refrigerated medications. I am excited to share my experiences and to discuss how we used metrics and data to meet our customers’ needs and to bring this product to market in record time.

Background

Refrigerated medications are often complex and costly medications to manage. Ensuring optimal refrigeration may be further complicated by various and disconnected workflows, disparate technologies, storage options and national drug shortages.

With a nearly completely saturated market in the U.S. acute hospital space, Automated Dispensing Cabinets (ADC) with single line item storage have long been accepted as the standard for medication storage and dispensing at the point of care. Refrigerated medications, however, are still an outlier.

In a study of acute care hospitals, it was found that, often, refrigerated medications are being locked in a refrigerator (either dorm-style, purpose-built or medical-grade) with a locking solution integrated with the ADC. Once the refrigerator is accessed, medications within the refrigerator are segregated with open bins. There are no physical barriers restricting the user from removing the wrong medication. Hence, there may be instances where vaccines may be mixed in with high-risk medications such as neuro-muscular blockers. The lack of single line item secure storage of refrigerated meds has led to patient safety incidents and diversion.

In instances where dorm-style and purpose-built refrigerators are being used, temperature management and excursions are a real concern. These non-medical grade units lack uniformity of temperature and temperature recovery. Failures of these subpar units have led to waste of inventory and even adverse events when ineffective vaccines that were stored outside of the acceptable temperature range were administered.

The disparity in practice between ambient temperature and refrigerated medications is due to the lack of a better refrigeration solution. Cumbersome work-arounds have been put into place, leading to workflow inefficiencies as well as waste due to short-dating and temperature excursions.

Metrics and data driven product development

As part of our development process, we engaged a third-party research firm to perform a qualitative and quantitative study of the current state of refrigerated med management in U.S. acute care facilities, including large IDNs.

The research was done to investigate:

• Customer need and value – what problem exists?
• Would the proposed solution deliver value – would it solve those problems?
• Willingness to pay

Based on market research, we decided to invest in the development of the product. We also considered the fact that the market is constantly evolving and that, to further test our assumptions, we would need prototypes. As we worked on them, we collected even more data, not only on features and functionality, but also pertaining to commercialization of the product.

We took our early prototypes to trade shows to get customer feedback. We engaged with some of our key customers through demos, presentations and surveys. Very quickly, we learned about some entirely new use cases and market segments for the product that were not found in the initial market research. Based on the data collected, we added new features and evolved our go-to-market strategy.

The next step was to see how the product worked in real customer environments. The workflows in different healthcare settings can be very unique. So, we built and deployed working prototypes in several different healthcare settings. This not only gave us confidence that the technology would meet user needs in all relevant environments, but also let us collect even more valuable data. This data was used to enhance the product further.

With Pyxis Refrigerator, frankly, we are still learning, as much as our customers are. We’ve used the approach of being partners and consultants for our customers rather than simply sellers of a product. We started with a set of assumptions, based on initial data collection. We partnered with our customers to validate those assumptions, who in turn helped us with more data to further refine our assumptions.

This agile approach is all about being objective. It’s about pivoting and sometimes even punting, with the intent of providing added value for our customers. And, in my opinion, metrics and data collection throughout the process of product development are truly the keys to creating a product that serves the needs of the market.

Becton Dickinson, Market Research, 2018

1. Cohen MR, Smetzer JL. ISMP medication error report analysis: paralyzed by mistakes – reassess the safety of neuromuscular blockers in your facility. Hosp. Pharm. 2017; 51(11):877-883.
2. Dorschner J. How did $14 million in drugs vanish from a UM pharmacy? Miami Herald. August 6, 2012. http://www.miamiherald.com/latest-news/article1941825.html. Access date: February 2, 2018.
3. Chase MA. Moving to a medication-grade refrigeration system. Pharm Purch Prod. 2014; 11(12):2-15.
4. Hibbs BF, Miller E, Shi J, Smith K, Lewis P, Shimabukuro TT. Safety of vaccines that have been kept outside of recommended temperatures: Reports to the Vaccine Adverse Event Reporting System (VAERS), 2008-2012. Vaccine. 2018; 36(4):553-558.

Rakhi Garg is driven by a vision to provide world class healthcare services to patients at an affordable cost. In her current role as Senior Product Manager at Becton Dickinson (BD), she is leading the Refrigerated Medication Management product portfolio. Previously, Rakhi worked for GE Healthcare’s Workforce Management. She has also worked with a digital health startup, Sense4Baby, which was acquired by Airstrip; and a venture fund investing in medical devices and healthcare technologies. Rakhi is a physician from India and has an M.B.A. from Rady School of Management, U.C. San Diego.