Att. A - SOW..pdf

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STATEMENT OF WORK

1. GLOSSARY OF TERMS;

VA – U.S. Department of Veterans Affairs

CMOP – Consolidated Mail Outpatient Pharmacy – VA’s high‐volume prescription filling unit.

VISTA/CERNER – VA’s central system for veteran’s EHR information storage & processing

APFS – Automated Prescription Fulfillment System

AUOU – see UUA below

BULK – Non‐NDC or high unit count pharmacy items on a prescription.

CDB –Central Database hosting the patient orders at VA’s central location

Combo Order –Combo Orders are orders that are placed in totes that require both TCA (puck) dispenses and UOU dispenses. These orders will have both vials containing tablet counted RXs and RXs dispensed from A‐Frames or Manual UOU dispensing.

Container – a logistical entity that contains tablet/capsule or a UoU retail pack dispensed on a Rx.

Sometimes referred to as Item being dispensed

CO/KO‐Contracting Officer

COR – Contracting Officer’s Representative

CS – Control Substance Prescription

Item – Drug or ancillary item. Sometimes interchangeably referred to as Container. See Container below.

NDC ‐ National Drug Code, a unique 10‐digit or 11‐digit code and universal product identifier for human drugs dispensed in a pharmacy. NDCs defines a specific manufacture, drug, strength, dosage form, and packaging code/quantity.

SW‐CMOP – Southwest Consolidated Mail Outpatient Pharmacy

NFPA – National Fire Protection Association

Package – A collection of one or more patient orders in a shippable form (bag/box/cooler etc.)

Patient Order – Identifies a single order to a specific patient and all the associated RX prescriptions contained in that order. Patient orders are unique to a package and may contain multiple RX prescriptions and multiple containers. For the purposes of this request, it can be assumed that there will be ONLY ONE

DELIVERY PACKAGE PER ORDER

PIL – Patient Information Literature

Project ‐ Pharmacy Printing and Packing Automation

POS – Pharmacy Operating System. Currently a McKesson system with some customization by QMSI.

There are no plans to change the POS.

Puck – A puck is a round polyethylene (Ultra High Molecular Weight Polyethylene) carrier that is specifically designed to transport vials through the dispensing process. Each carrier is uniquely identified

Page | 2 and contains an RFI chip located in the bottom of the carrier. Puck are used for tracking patient containers through the pharmacy. Each puck measures approximately 3‐3/4" wide at the base and is 3" tall with a 2‐ 1/4" center hole. Center hole is approximately 2‐1/4" deep. Some pucks have a plastic insert that stands out an additional 1" tall and makes the center hole approximately 1‐3/4" diameter center hole to accommodate smaller vials.

TCA ‐ Tablet and Capsule Automation Subsystem

Throughput – The amount of material or items passing through a system or process.

Tote – A tote is a plastic six‐sided container open on top for access. The tote contains an RFI tag in the center of the bottom side for tracking and routing. Each tote container has a unique system ID number and a tote typically contains a single patient order. The tote dimensions are 15 inches long by 11 inches wide by 9 inches high. In some instances, totes can contain multiple, single container customer orders and are referred to as “super totes.”

Tote Marriage – Tote Marriage is the process of removing vials from pucks and placing the vials into an empty tote for combo orders. The Tote Marriage area is the first decision point for empty order tote and totes may by‐pass the tote marriage if no TCA RXs are required for the patient order.

Tote Return – Tote Return is the conveyor used to return empty totes to the start of the tote portion of the APFS. The empty tote return will be a separate conveyor to the full tote delivery conveyor from the

APFS.

TSP – Tote Semi‐Auto Packer – A type of staffed packing workstation assisted by electro‐mechanical devices commonly used in order fulfillment operation

UoU – Unit of Use

UUA ‐ Unit of Use Automation.

Operational Terms:

ACK ‐ Acknowledge

CONTAINER – Labeled item in patient order (some Rxs can contain multiple containers). Can be either:

NAK – Non‐Acknowledge

NEW RX – First fill of the patient prescription

ORDER – Single mailing unit to patient with all requested items/prescriptions

REFILL RX – Refill of existing patient prescription

RX – Prescription from physician to patient

Tablet/Capsule Vial (ex: countable pills in a bottle)

UOU – Unit of Use Container (ex: retail pack format)

Order Type Definitions:

MANUAL – Orders filled entirely in manual work area currently

TOTE – Orders that will reach their pack area in totes; this includes orders with:

UOU: >=1 UOU containers dispensed from the Sam Jared AUOU work area

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COMBO: >=1 UOU container and >=1 TCA container dispensed from AUOU/ATD, respectively

VIAL – Orders that will reach their pack area in vials; this only includes orders with all RX(s) dispensed at counted tablets or pills.

Area Definitions:

ATD‐Automated Tablet Dispensing

AUOU‐Automated Unit of Use Dispensing

MTD – Manual Tablet Dispensing

MUOU – Manual Dispensing for Unit of Use Items

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1. OVERVIEW

The United States Department of Veterans Affairs Consolidated Mail Outpatient Pharmacy (VA CMOP) processes over 500,000 prescriptions per day at seven regional pharmacies. Prescriptions are entered into the patient’s Electronic Health Record (EHR) at VA hospitals and clinics, then transmitted to the assigned CMOP for processing and mailing to the veteran. The current EHR is an older, homegrown, legacy system called VISTA that will be phased out during this decade and replaced by a new, Cerner‐based, Commercial‐off‐the‐shelf (COTS) solution. Current estimates are to have all VA facilities fully operational on Cerner by 2028. It is unknown when this replacement will affect specific CMOPs; however, suppliers should assume that the changeover will not affect proposed solutions to this Request for Quote (RFQ) and that no direct interfaces to the EHR will be required.

Currently, the Southwest CMOP processes an average of 77,000 scripts per day in a two‐shift operation.

The VA CMOP desires to increase the amount of automation within the Tucson location to as much as 110,000 scripts per day in a two‐shift operation. This RFQ is designed to support that initiative. The VA recently purchased the building in which the SW CMOP resides. This has allowed the VA to take a longer‐ term approach to increasing throughput and labor efficiency in the facility. This procurement effort is design to support that initiative.

This RFQ is intended to solicit quotes for the facility's current packing areas where operator‐assisted printing and packing are to be provided. Fully automated printing and packing are currently NOT desired for this effort. Suppliers may propose a fully automated solution as an alternative, but past performance on such a system across the CMOP network is poor. A semi‐automated solution is highly desired due to this past performance.

Quotes will be evaluated to select the best, most reliable automation support and the most cost‐effective means providing the best value solution for the Southwest CMOP.

The specific area to add automation is:

Semi‐Automated Print and Pack – In the SW CMOP, product is picked and dispensed manually and automatically then sent to labeling and pharmacist verification (PV2) stations via a conveyor system.

Packing is completed after PV2, where Patient Information Verification (PIV) sheets are generated, added to the bag, and the order sealed. For large volume orders, some of the manual packing stations will pack into corrugated boxes; however, most orders are packed into bags. Sealed orders are placed in a bulk mail container for ultimate transportation to a third‐party facility for mailing to the veteran (typically via

USPS).

All puck Rxs (puck only or as part of a combination order) are automatically labeled in the current system.

UOU items are manually labeled.

VACMOP is requesting a turn‐key solution for the addition of semi‐automated packaging machines to service the existing system. Full integration with the existing system is required, including additional conveyor logic and transfers to integrate with the existing system.

POS is the overall pharmacy‐operating system utilized in the operation. POS is also the primary interface to the EHR for this operation. The VA will be responsible for funding and coordinating required changes to the POS to support their designs. Vendors should budget support of interface meetings with the VA’s POS experts.

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Select areas in the pharmacy receive work from POS, process the work, and report back to POS. This is the desired approach for the printing and packing automation to be added to the pharmacy. This requires an interface to POS both to receive information defining the work to be done and to return the completed work information back to POS to close out the order.

Upgraded Conveyor – The Southwest CMOP is also wanting upgrades to the tote conveyor in the tote marriage area and the tote conveyor interfacing with the existing A‐Frame automated Unit of Use dispensing, subject to availability of funding. The tote marriage area and the conveyor upgrades are considered separate and stand‐alone from the Semi‐Automated Print and Pack areas but the base, Option 1 and Option 1A shall all be quoted. It is the Southwest CMOPs intent to consider the upgrades to these additional areas as options to the main Semi‐Automated Print and Pack quotation that will be purchased as add‐ons if sufficient funding is available. Contractor shall provide pricing for the base semi‐automated print and pack area as well as options 1 (Tote Marriage with A‐frame Recirculation Conveyor) and option 1A (Tote Marriage with A‐frame supply and recirculation Conveyor infeed and outfeed) as defined in section 1.11 below. Option 1 is an add on to the base requirement, and option 1A is an add on to the base and Option 1 requirements. Our goal is to purchase at the Option 1A requirement level if sufficient funding is available. If sufficient funding is not available for Option 1A, we will drop down to Option 1 and then the base requirement, within our funding limitations.

1.1. Facility Location

US Department of Veterans Affairs

Southwest CMOP

3675 East Britannia Drive

Tucson, AZ 85706

1.2. Confidentiality

VA CMOP considers all equipment, systems, distribution processes, and documentation relating to such equipment, systems, and processes to be confidential and proprietary information. The Supplier will not distribute, disclose, or disseminate, in any way, such information to anyone except its employees who are involved in this quote/offer response effort.

All information relating to this Project is considered confidential information. This includes not only technical and requirements information but also non‐technical information such as costs, prices, and sizes of equipment, quantities, material, etc. The Supplier agrees to keep such information in confidence. No information relative to the Project shall be released by the Supplier, either before or after completion of the project, for publication or advertising purposes without the prior written consent of the US Department of Veterans Affairs (VA).

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1.3. Drawings Supplied

Plan views of the existing and planned Tucson pharmacy are provided to scale in the attached drawing files. Two options are provided: one with a design of A‐frame infeed and out‐feed conveyor (Att. 3‐Option 1A, Att. 2‐Option 1) and one using the existing configuration Att. 1‐Current State.

Additionally, a number of .pdf markups are included that match figures in this document and should be considered explanatory in nature. AutoCAD versions of the attached pdf’s are available upon request.

An approximate location and quantity for the equipment is identified.

Please note that due to COVID travel restrictions, the current state drawings are close estimates of current state conditions at Tucson. Suppliers will be afforded the opportunity to visit the facility in advance of the due date of this quote, subject to public health restrictions. Should such restrictions not support a visit, CMOP will take steps through photos and videos to explain the applicable operation in the facility.

1.4. Supplier Past Performance

Suppliers should recognize that the Purchaser’s selection team will desire to visit one or more installed and operational sites in an analogous environment and be should be prepared to support these requests. In lieu of travel, the Purchaser evaluation team may choose to interview past performance references without the presence of the Supplier.

1.5. Technical Submissions with the Quotation

The Supplier should also recommend content and quantity of spare parts that should be maintained by the Purchaser with prices and estimated delivery times. This information shall be submitted with the quotation.

All physical characteristics of the proposed equipment are to be submitted. These include the critical dimensions related to length, width, height, capacity, and clearances.

Mechanical and electrical requirements (power, voltage, current, etc.) of the Supplier’s proposed solution should be provided.

Any and all control software / systems and its interfaces to operating the Supplier equipment should be clearly specified and called out.

Numerous requirements are elicited in this RFQ. Suppliers are advised to respond in as much technical detail as possible with the quotation.

Submissions shall contain a supplier‐developed plan view and elevations as required to demonstrate the supplier proposed equipment installation details. The equipment numbers provided in the drawing should match the Supplier’s proposed solution.

1.6. Training, Maintenance, and Warranty Submissions

Suppliers are requested to submit information regarding available services for repair and maintenance. Such shall include the names and locations of a local representative, service hours, factory branches, or manufacturer’s representatives capable of supplying spare parts, maintenance, and warranty service to the Purchaser’s facility.

The Supplier is to provide training for the Purchaser in the proper repair and preventive/corrective maintenance of the equipment.

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The Supplier shall provide a listing of the top three repairs to be expected for each type of electro‐ mechanical system proposed, necessary corrective action, and the expected mean time between failures for these occurrences.

The equipment shall be warrantied for workmanship, materials, design, installation, and performance for a period of time to be agreed upon from day of beneficial use at VA CMOP. Specific warranty and guarantee information is to be submitted with the quotation. For all key subcomponents (defined as those listed on the recommended spare parts inventory list), vendors should provide information from subcomponent suppliers on the anticipated life cycle of each key subcomponent. Warranty offerings will be considered in the quotation evaluation.

Any warranty should be a minimum one‐year unconditional extended warranty, which will include all parts and labor. Normal wear items are excluded.

1.7. Prices, Risk of Loss, and Title

All prices quoted shall be in US dollars utilized at the date of the quotation. The pricing proposed is to be FREIGHT ON BOARD (FOB) to the VA CMOP Pharmacy in Tucson, AZ. Notwithstanding the FREIGHT ON BOARD point, risk of loss, or damage to the materials and title, the material shall remain with the Supplier and shall pass to the Purchaser only upon Acceptance.

1.8. Exceptions and Alternates

Exceptions taken to the base scope, technical requirements, working conditions, project management requirements, or commercial terms and conditions are to be clearly noted in the Supplier Quotation.

Suppliers are encouraged to present, as alternatives, any changes or modifications that would improve the overall operations or offer a cost‐reduction potential to the Purchaser with no impairment to the performance requirements set forth in the RFQ. Such modifications shall be presented in the form of an addition, deletion, or substitution to the base quote described in the RFQ.

Layout and elevation drawings of alternatives or modifications will add clarification to such submittals.

1.9. Quote Contents

Suppliers are required to follow the prescribed format and supply all required information to be considered in the evaluation. Furthermore, all quotations must reflect the requirements identified in this request with no deviations. The quotation format will be as follows:

1.9.1. Attachment 1 ‐ Project Overview

A narrative summary identifying the Supplier’s understanding of the job content and an overview of the proposed system shall be provided.

1.9.2. Attachment 2 ‐ Product Information

All available product literature, including technical literature relating to the equipment and operating software required for this project, shall be supplied as part of the quotation.

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1.9.3. Attachment 3 ‐ Subcontractors and Suppliers

A list of all planned suppliers/subcontractors shall be attached to the Offer Form. The list shall contain the names and addresses of tentative suppliers/subcontractors and identify major components or services that would be provided. The socio‐economic status of any proposed subcontractor should be provided. Written confirmation from key subcontractors that they have agreed to be part of the supplier’s team should be provided. Prior to the award of any contract, the Purchaser must approve the actual suppliers/subcontractors.

1.9.4. Attachment 4 ‐ Supplier Offered Alternatives

The base quotation is to be proposed per this RFQ, which should include all “standard” equipment and will consist of the “minimum” design requirements set forth by this request. HOWEVER, SUPPLIER‐OFFERED ALTERNATIVES ARE SOLICITED WHERE THE SUPPLIER FEELS THE

PERFORMANCE OF THE SYSTEM CAN BE IMPROVED. A DESCRIPTION OF THESE OPTIONS AND THE

COST IMPACT OF EACH MUST BE CLEARLY IDENTIFIED AS AN “ADD,” “DEDUCT,” OR

“ALTERNATIVE” FROM THE BASE QUOTATION.

1.9.5. Attachment 5 ‐ References and Qualifications

A list of current and/or recently completed projects of similar scope and nature showing contract value, type of system supplied, and when completed, shall be provided in the quotation. A contact’s name and phone number for each project shall be included. A minimum of three such projects are to be listed. Contacts provided should be knowledgeable in the history of the installation, operating performance, and maintenance history of the installation. Contacts in the Southwest region are preferred but need not be limited to this geographical area. If applicable, federal government procurements should be included.

1.9.6. Attachment 6 ‐ Technical Submissions

As described in section 2 and section 3 of this document.

1.9.7. Attachment 7 ‐ Training, Maintenance and Warranty Submissions

As described in section 11 and section 15 of this document.

1.9.8. Attachment 8 ‐ Bill of Materials

A complete Bill of Materials shall be supplied with the quotation reflecting total component quantities, required software, delivery weight, and expected number of truckloads to be shipped.

1.10. Oral Presentations

In addition to the written response Suppliers may be invited to conduct oral presentations, such invitations will be at the discretion of the VA and will take place at the Southwest CMOP, unless public health conditions dictate doing so remotely.

Travel and labor funding for oral presentations will be the responsibility of the Supplier. The Government will not provide any reimbursement for oral presentations.

1.11. Quote Options

The quote should be broken into the following options for consideration:

1.11.1. Semi‐Automated Packaging Base Quote

The base quote should include the following areas:

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Semi‐Automated Puck Packaging o Att. #2 (option 1), Att. #3 (option1A) Includes 5 and 4 in each pack area for a total of 9 stations (includes future considerations) o This solicitation is for 3 stations in each area for a total of 6 stations (or the number determined by the vendor to meet design year packaging demand for puck pack area)

Semi‐Automated Tote Packing o 8 Semi‐Automated Tote Pack Stations o 2 Manual Tote Pack Stations (Box Pack Stations)

Flex Link Puck Conveyor to Support Puck Packing

Tote Conveyor to Support Tote Packing o Tote Sorting to Pack Stations o Pack Station Queues o Empty Tote Return o Tote Recirculation for Packaging

1.11.2. Option #1 Tote Marriage w/A‐frame Recirculation Conveyor

Option #1 should include the following areas:

De‐puck Robots and Accumulation Tables o 2 Robots and 2 Accumulation Tables for Multiple Products

Vial Transfer to Empty Totes

Tote Conveyor to Support Tote Marriage o Inbound Empty Totes o Tote Recirculation in Tote Marriage o Tote Diverts to De‐Puck

Manual Unit of Use Dispense Stations (2 stations) o Tote Diverts o Work Queue Conveyors

Manual Unit of Use Exception Stations (2 stations) o Tote Diverts o Work Queue Conveyors

A‐Frame Recirculation Conveyor w/Diverts

1.11.3. Option#1A Tote Marriage w/A‐frame Supply and Recirculation Conveyor

Option #1A should include the following areas:

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De‐puck Robots and Accumulation Tables o 2 Robots and 2 Accumulation Tables for Multiple Products

Vial Transfer to Empty Totes

Tote Conveyor to Support Tote Marriage o Inbound Empty Totes o Tote Recirculation in Tote Marriage o Tote Diverts to De‐Puck

Manual Unit of Use Dispense Stations o Tote Diverts o Work Queue Conveyors

Manual Unit of Use Exception Stations o Tote Diverts o Work Queue Conveyors

A‐Frame Supply Conveyor o A‐Frame Diverts and Merges o A‐Frame In‐feed / Out‐feed Conveyor

A‐Frame Recirculation Conveyor w/Diverts

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2. PROJECT SCHEDULE

2.1. Project Schedule Requirements

As part of the quotation, Suppliers are to provide a proposed schedule for the work. The Purchaser envisions the schedule, at a minimum, to encompass the events identified in the table below. The Supplier shall perform the work in phases. With the quotation, the Supplier shall submit a firm schedule for the system delivery and installation. As a minimum, this schedule shall detail the elements and duration relating to the following milestones. It is expected that fabrication, shipment, and installation will be overlapping and concurrent activities.

Event Date

Functional Design Review and Approval TBD

Functional Acceptance Test TBD

Start Delivery to Site TBD

Installation, Training, and Commissioning Complete

TBD

Customer Use of the Equipment TBD

Complete Acceptance – Reliability Complete TBD

2.2. Project Schedule Submissions

With the quotation, the Supplier shall submit a firm schedule for the packing automation being quoted. At a minimum, this schedule shall detail the elements and duration relating to the following milestones.

1. Functional Design Review and Approval by Purchaser. This milestone constitutes the approval of the equipment design for the physical layout and mechanical configuration. All design criteria listed in the RFQ must be met. This approval does not relieve the equipment Supplier of the responsibility for the operational or structural integrity of the designs. Functional design review/approval meetings will be held at the Southwest CMOP in Tucson, AZ, or remotely if public health conditions dictate.

2. Fabrication Timeline. This milestone constitutes a schedule approval for the procurement and fabrication of major components. This schedule shall be reviewed and updated by the Supplier with approval by the Purchaser or Purchaser’s COR.

3. Factory Acceptance Testing – FAT‐ component testing at the Supplier’s facility prior to shipping to the site.

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4. Shipment to Site. This milestone constitutes the approval by the Purchaser of the scheduled delivery date(s) to the job site. Any deviations from the required schedule defined in this document are to be approved in writing at least ten working days prior to shipment.

5. Installation Timeline. Upon receipt at the facility, the equipment components will be unloaded by the equipment Supplier. The Purchaser reserves the right to make a complete inspection of the delivered materials at this time. Upon approval, the Supplier shall begin or continue installation, training, and commissioning as required for the respective system.

6. Acceptance. The Purchaser shall conduct acceptance testing as defined in this RFQ. The Supplier shall be responsible for a quality, reliable product that meets the criteria, capacity, and loading described in all sections of this request. Beneficial use of the equipment may take place before full project installation and acceptance are complete.

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3. OPERATIONAL REQUIREMENTS

3.1. General Pharmacy Process

The Southwest CMOP fulfills prescription medications from the VA Health Facility Network to patients via mail order prescription fulfillment. The operation handles drugs as either counted tablets in vials and/or unit of use drugs in manufacturers packaging. Each prescription is dispensed, labeled with a unique patient label, is pharmacist verified, is consolidated/sorted (if required), and is packaged for shipment.

The diagram below graphically illustrates the fulfillment process within the Southwest CMOP facility:

Southwest CMOP – General Pharmacy Flow Diagram

This project will address the manual packaging following the Pharmacist Verification process for pucks and totes, depending on the order requirements. Currently, there is no automation after the pharmacist verification for tote orders and after the sorting of pucks based on the number of pucks in the order.

All manual packaging is connected to the system by conveyors, and the system handles the routing of totes and pucks to specific manual workstations. Although the routing of orders is automated within the system, the current manual process contains non‐automated tasks, which are non‐value‐added activities. These include waiting for literature, retrieving totes, manually handling packaging materials, and manual movement of packed orders, which all significantly contribute to packing inefficiency and low pack rates per station.

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The following sections describe the overall pharmacy operations and design approach to be followed when designing the packaging automation to be applied for this program. The overall pharmacy operations are provided as general background for a complete understanding of the fulfillment process and flows feeding the packaging areas.

The primary goal of introducing automation in the packaging process is two‐fold. First, the VA wishes to increase the productivity and capacity of the current packaging area. This will allow for more production from the same or reduced footprint. This would be accomplished through the elimination of non‐value‐added manual tasks currently performed in the packing operation.

Second, the VA wishes to improve quality and reduce the potential for errors that could ultimately go to the customer patients. Currently, quality, and patient errors in packaging are not a concern for the VA; however, there are concerns with quality and automation based on previous experience within the VA. Verification scans, system safeguards, lockouts, and other safety features that can be built into the automation will greatly improve quality and safety and the overall confidence in automation.

3.1.1. Current Pharmacy Layout

Below is the Current Southwest CMOP pharmacy layout with the areas highlighted for upgrades in this quote.

3.2. Operational Option Areas

Below are the layout illustrations for each option of this quote.

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3.2.1. Base Semi‐Automated Packaging Option

The Base Option includes the Semi‐Automated Packaging Stations in puck packing and tote packing highlighted below:

3.2.2. Option #1 Tote Marriage w/A‐frame Recirculation Conveyor

Option #1 includes the Tote Marriage Area and the A‐Frame Recirculation conveyor loop highlighted below:

3.2.3. Option#1A Tote Marriage w/A‐frame Supply and Recirculation Conveyor

Option #1A includes the Tote Marriage Area and the A‐Frame Supply and Recirculation conveyor loop highlighted below:

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3.3. General Equipment Requirements

3.3.1. Preferred Tote Conveyor Requirements

Tote conveyor is anticipated to be primarily 1.9‐inch diameter motor driven roller conveyor used to transport totes between system automation upgrades from tote pack through tote marriage and the A‐frame. Smart conveyor that provides the most flexibility to adjust zones of accumulation (e.g. shifting from slug to singulation mode) is preferred. Conveyor that automatically shuts down while not in active use after a fixed period of time is preferred. The locations and parameters shall be approved by Southwest CMOP.

All tote conveyor will be equipped with side rails as required to ensure totes remain in the system.

The Supplier shall support the ability to turn off workstations as required based on workload.

3.3.2. Preferred Sortation Requirements

The sortation requirements for future tote diverts or tote sorting are prescribed below. These requirements should apply to any 90‐degree tote transfer or sort unless otherwise noted on the drawings as an angle other than 90 degrees. These requirements include:

High throughput – The sort diverts must be high throughput capability and handle the number of sorts expected based on the conveyor speeds needed. An estimated max of 2,000 totes per hour could be seen in the peak hour in the design year across all 8 semi‐ auto packing stations.

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Low profile – There are sections in packing and the A‐frame feed areas that may require over/under conveyor with sort points on the upper or lower conveyor. Given the clearance between conveyors and tote height, it is desired to have low profile sorters to avoid extreme elevation changes in conveyor levels. The empty tote takeaway will run directly underneath the sorter so having a low‐profile sorter that allows this is critical

Non‐pusher Diverts – The Southwest CMOP has mandated NON‐PUSHER DIVERTS be installed. Currently most of the existing diverts are mechanical pneumatic pushers. These pushers are very noisy, slow, and sometimes miss diverts and create issues in the tote line.

90 deg transfer – Unless otherwise noted, 90‐degree transfers are required due to tight space requirements and overall footprint available for new equipment upgrades. Any other type of transfer will limit the amount of equipment in the space provided. The exception to this is diverts into the A‐Frame in Option 1A which can be 30‐ or 45‐degree spurs.

200 ft per min – The conveyor speeds should have the capability of at least 200 ft per minute. Any sorter or divert should be able to accommodate conveyor speeds at least in this range. The current tote conveyor speeds range from 65 to 68 ft per min.

Appropriate gapping of totes – Sorters and conveyors should be able to appropriately gap totes for diverts or sorts. Gapping will be required to insure correct sorting of totes and reduction in the amount of recirculation.

3.4. Packaging Process

The current packaging process at the Southwest CMOP is a manual process. Orders are manually packed in polybags or boxes for shipment via USPS delivery. There is no pre‐sorting of packages prior to shipment. All packages are placed on an overhead belt conveyor, which transports packaged orders for outbound shipment. Packages are directly loaded from the belt conveyor into USPS Bulk Mail Containers for transport to a third‐party mailer for sorting and manifesting.

The packaging areas are divided up by puck and tote packing. Each pack station contains a work surface, storage for packaging materials, a printer for patient literature, a printer for patient shipping labels, a tethered barcode scanner, and a workstation computer terminal with a monitor.

Each packing area has an outbound package belt conveyor. The conveyor from the tote area merges onto the conveyor for the puck area. The combined flow of completed packages terminates at the end of the pharmacy in the shipping dock area.

Currently, there are 36 manual tote pack stations and ten manual puck packing stations (five single pucks/five multi‐pucks). It is anticipated that pack stations' current locations be maintained with minimal impact to the conveyor systems feeding. It is anticipated that an additional puck or tote conveyor may be required to connect new pack stations to the existing transport conveyor system.

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3.4.1. Manual Puck Packing

3.4.1.1. Overview

Manual puck packing is located in two separate areas opposite the automated dispensing models and adjacent to puck pharmacist verification, capping, and sealing. Each puck pack area has five manual pack stations. The stations are dedicated to single puck orders and multi‐ puck orders. The multi‐puck orders contain a small order accumulation conveyor, and the single puck orders are conveyed to a robotic de‐puck gantry, which removes the vials and places them onto a conveyor feeding directly into the single puck pack station.

3.4.1.2. Current Pack Layout

SOUTHWEST CMOP – Current Manual Puck Pack Station (Dedicated Single – Puck)

SOUTHWEST CMOP – Current Manual Puck Pack Station (Dedicated Multi-Puck)

3.4.1.3. Current Puck Pack Process

Below are the current process steps for completing the packaging of puck only orders for multi‐puck orders and single puck orders.

Current Multi‐Puck Pack Process:

1. Grab one vial from puck in order queue

2. Select and open polybag

3. Scan patient label on vial with barcode scanner

4. Label scan triggers patient literature to print

5. Verify correct item on order with monitor

6. Place vial into polybag

7. Place empty puck on takeaway conveyor

PRINTER

WORK TABLE

EMPTY PUCK

RETURN

PUCK

INBOUND

OVERHEAD

PACKAGING BELT

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8. Repeat steps #2 through #7 for each vial on patient order

9. Place refill information into bag

10. Wait for patient literature to complete printing

11. Scan patient literature 2X with barcode scanner

12. Fold patient literature and place into polybag

13. Peal polybag seal, close and seal polybag and place waste material in trash

14. Retrieve shipping label from label printer

15. Place shipping label on polybag

16. Scan shipping label

17. Place polybag on holding shelf until next order is complete then place on belt, mail, conveyor

Current Single‐Puck Pack Process (singles at puck pack station):

1. Grab one vial from conveyor

2. Select and open polybag

3. Scan patient label on vial with barcode scanner

4. Label scan triggers patient literature to print

5. Verify correct item on order with monitor

6. Place vial into polybag

7. Place refill information into bag

8. Wait for patient literature to complete printing

9. Scan patient literature 2X with barcode scanner

10. Fold patient literature and place into polybag

11. Peal polybag seal, close and seal polybag and place waste material in trash

12. Retrieve shipping label from label printer

13. Place shipping label on polybag

14. Scan shipping label

15. Place polybag on holding shelf until next order is complete then place on belt, mail, conveyor

3.4.1.4. Proposed Puck Pack Process

Below are the proposed process steps for completing puck only orders'’ packaging for multi‐ puck orders and single puck orders. It is proposed that new packing station designs should have the flexibility to pack both order types without change‐over or reconfigurations.

Future Proposed Multi‐Puck / Single Pack Process:

1. Pucks enter local pack station queue for puck pack

2. Triggers patient literature to print

3. Pucks released to pack position and presented to pack operator

4. Bagger automatically indexes bag, laser prints patient shipping label on bag and scans shipping label to confirm correct label and readability.

5. Operator selects one vial from puck

6. Scan patient label on vial with fixed barcode scanner

7. Verify correct item on order with monitor

8. Place vial into polybag

9. Repeat steps #5 through #8 for each container on patient order

10. System directs operator to specific tray with patient literature and refill information pre‐printed (tray will also have light indicator)

11. Pull literature packet from tray with fixed upper and lower scanners (scan top of first page and bottom of last page simultaneously)

12. Fold patient literature and place into polybag

13. Bagger automatically seals bag

14. Bagger automatically drops to conveyor with feed to overhead takeaway conveyor

15. Empty pucks automatically released on conveyor

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3.4.2. Manual Tote Packing

3.4.2.1. Overview

Below are the current process steps for completing packaging tote orders. Currently, tote packing includes packing regular tote orders and supertotes. The process for supertotes is identical to single puck pack except that there are multiple orders in a single tote, and the orders can be vials (pucks) or unit of use items dispensed. Each item has a specific unique patient label and is for a unique patient order.

3.4.2.2. Current Tote Station Layout

SOUTHWEST CMOP – Current Manual Tote Pack Station

3.4.2.3. Tote Size

Current tote size is 15.0” long (in the direction of conveyor travel) x 10.75” wide X 8.5” high.

It is desired to utilize the current tote in the renovated system.

3.4.2.4. Current Tote Pack Process

Below are the current process steps for completing the packaging of tote orders for unit of use only and marriage (unit of use and puck) orders.

Current Tote Pack Process:

1. Grab tote from conveyor and place to staging area

2. Grab one container from tote

3. Select and open polybag

4. Scan patient label on container with barcode scanner

a. Label scan triggers patient literature to print

5. Verify correct item on order with monitor

6. Place container into polybag

7. Repeat steps #3 through #6 for each container on patient order

8. Place refill information into bag

9. Wait for patient literature to complete printing

10. Scan patient literature 2X with barcode scanner

11. Fold patient literature and place into polybag

12. Peal polybag seal, close and seal polybag and place waste material in trash

13. Retrieve shipping label from label printer

14. Place shipping label on polybag

15. Scan shipping label

16. Place polybag on holding shelf until next order is complete then place on belt, mail, conveyor

17. Place tote back on conveyor

Work Table Terminal Inbound Totes Outbound Packages

Printer

Outbound Empty Totes

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3.4.2.5. Current Super Tote Pack Process

Below are the current process steps for completing super tote orders at tote stations. Super totes can contain all single unit‐of‐use container orders or all single puck orders. Unit‐of‐use and pucks are NEVER mixed in super totes.

Current Single‐Puck Pack Process (super tote pack at tote pack):

1. Grab one vial from off‐line tote

2. Select and open polybag

3. Scan patient label on vial with barcode scanner

a. Label scan triggers patient literature to print

4. Verify correct item on order with monitor

5. Place vial into polybag

6. Place refill information into bag

7. Wait for patient literature to complete printing

8. Scan patient literature 2X with barcode scanner

9. Fold patient literature and place into polybag

10. Peal polybag seal, close and seal polybag and place waste material in trash

11. Retrieve shipping label from label printer

12. Place shipping label on polybag

13. Scan shipping label

14. Place polybag on holding shelf until next order is complete then place on belt, mail, conveyor

3.4.2.6. Proposed Tote Pack Process

Below are the proposed process steps for completing the packaging of tote orders and super tote orders. It is proposed that new packing station designs should have the flexibility to pack both tote types without change‐over or reconfigurations.

Future Proposed Totes/Super Tote Process:

1. Tote enters local queue for tote pack station

a. Triggers patient literature to print

2. Tote enters pack position and is presented to pack operator

3. Bagger automatically indexes bag, laser prints patient shipping label on bag and scans shipping label to confirm correct label and readability.

4. Operator selects one container from tote

5. Scan patient label on container with fixed barcode scanner

6. Verify correct item on order with monitor

7. Place container into polybag

8. Repeat steps #3 through #6 for each container on patient order

9. System directs operator to specific tray with patient literature and refill information pre‐printed (tray will also have light indicator)

10. Pull literature packet from tray with fixed upper and lower scanners (scan top of first page and bottom of last page simultaneously)

11. Fold patient literature and place into polybag

12. Bagger automatically seals bag

13. Bagger automatically drops to conveyor with feed to overhead takeaway conveyor

14. Tote is automatically released on conveyor

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3.4.3. Southwest CMOP Workstation Configuration Requirements

The illustrations below show the planned concept and approximate configuration of the semi‐ auto packing equipment in the new puck pack and tote pack areas. Please note that the number and dimensions of the equipment shown are notional in nature and should be adjusted to match the Supplier’s proposed solution.

Puck Pack Workstation Configuration

The puck pack station configuration shows the following requirements for Semi‐Automated Puck Pack Stations:

Local Station Order Accumulation Queue – The station must have the ability to accumulate multiple pucks for each patient order and release to the operator when all pucks are present. The pucks in a single order must remain together from the time of release from queue until pack is completed by pack operator. NOTE: it is expected future pack stations will pull pucks from existing puck conveyor in the system and divert into local order accumulation queues. The station interface should tie into the existing inbound puck feed conveyor.

Auto Bagger – Auto bagger placed in front of operator for efficient ergonomic operation

Printer – Printer for patient literature packs to be inserted into packages. Must be positioned ergonomically that the operator does not have to move to retrieve literature packs. Printer must be able to queue multiple orders in advance of the arrival of the patient order based on the orders accumulating in the local station work queue.

Inbound Puck Queue – This is the working queue the operator is packaging from. This work queue must provide the operator with a steady stream of work to package without interruption or breaks in the packaging process.

Package Take‐away Incline Belt – The finished patient order packages must be conveyed away from the pack station automatically, incline overhead and dump on to a central package take‐away conveyor located over the package area. The central conveyor will terminate in the dock area where packages will dump into a USPS bulk mail container at the end of the packaging line. NOTE: The centralized packaging take‐away conveyor is currently in place and it is expected that future pack stations will integrate to the conveyor and utilize existing belt conveyor equipment.

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Proposed Puck Pack Station Concept Layout

Proposed Layout Detail of Puck Pack Area

Elevation View of Puck Pack Area

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Tote Pack Workstation Configuration

The tote pack station configuration shows the following requirements for Semi‐Automated Tote Pack Stations:

Auto Bagger – Auto bagger placed in front of operator for efficient ergonomic operation

Printer – Printer for patient literature packs to be inserted into packages. Must be positioned ergonomically that the operator does not have to move to retrieve literature packs. Printer must be able to queue multiple orders in advance of the arrival of the patient order based on the orders accumulating in the local station work queue.

Inbound Tote Queue – The station must have the ability to accumulate multiple totes for each patient order to include “super tote” orders. Each workstation will have a single queue that the operators will work from. The proposed queue is shown as nine totes.

Outbound Empty Tote Take‐away – Each pair of tote pack stations will share an empty tote take‐away conveyor. This conveyor will automatically remove empty totes from the workstations and convey the totes to a central empty tote conveyor placed below the inbound tote conveyor. NOTE: based on future estimated volumes the separation of empty totes from inbound full totes is required to prevent congestions in the feed diverts and excessive tote recirculation due to missed diverts.

Tote Diverts – Totes diverts must be able to handle 35 to 40 Totes per Minute and be low profile to accommodate an over/under conveyor configuration.

Package Take‐away Incline Belt – The finished patient order packages must be conveyed away from the pack station automatically, incline overhead and dump on to a central package take‐away conveyor located over the package area. The central conveyor will terminate in the dock area where packages will dump into a USPS bulk mail tote at the end of the packaging line. NOTE: The centralized packaging take‐away conveyor is currently in place and it is expected that future pack stations will integrate to the conveyor and utilize existing belt conveyor equipment.

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Proposed Tote Pack Station Concept Layout

Proposed Layout Detail of Tote Pack Area

Elevation View of Tote Pack Area

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3.5. Tote Marriage Area

The tote marriage area is designed to consolidate patient orders containing dispenses from multiple areas of the pharmacy to be placed into patient order totes. The dispenses from tablet counting (pucks) and unit of use (a‐frame) are dispensed from different automation systems and are not connected. The two systems are connected in the tote marriage area.

3.5.1. Current Tote Marriage Area

The current tote marriage area contains two de‐puck units. The de‐puck units remove completed patient vials from pucks and place them into patient order totes. Once the completed vial has been removed the empty puck travels back to the tablet counting automation area for reuse in the next patient tablet order.

Empty totes arrive at the de‐puck units on tote conveyor directly below the de‐puck robots. The robots drop completed vials below to the empty tote. The patient order is assigned to the tote when the patient vial is dropped into the tote.

Each de‐puck robot is a gantry style robot that can hand up to 4 vials per cycle. Each robot is serviced by a puck order accumulation area that consolidates the pucks for each order. There are 4 banks of 4 lanes for each robot for a total of 16 order accumulation lanes for each robot. Each lane can hold up to 4 pucks.

Current Tote Marriage Configuration

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3.5.2. Proposed Tote Marriage Area

The proposed tote marriage area concept is designed to significantly reduce the space required to complete the tote marriage and add functionality to the system that does not currently exist in the APFS conveyor layout. The proposed tote marriage area utilizes a robotic arm unit to de‐ puck and accumulate pucks on an accumulation table that acts as both a puck buffer and order accumulator. The robots remove vials from pucks and place the lone vial on the table. After all vials for a specific order are present the robot can access all vials for a specific order from any location on the table and place them together into an empty tote waiting on the conveyor below.

Each de‐puck robot should be able to handle between 150 and 200 order vials each. In addition, all vial holding locations on the accumulation table should accommodate two vial sizes, a small 120 cc vial and a large 250 cc vial.

The proposed tote marriage area will operate in the same manner as the current tote marriage area. Empty totes arrive at the de‐puck units on tote conveyor directly below the de‐puck robots.

The robots drop completed vials below to the empty tote. The patient order is assigned to the tote when the patient vial is dropped into the tote.

Robotic de‐puck system must be capable of processing approximately 12,000 vials per shift or 24,000 vials per day over a two‐shift operation. On a 16 hour, two‐shift operation, this would be an average of 1,500 vial containers per hour or 25 vials per minute total. The processing includes removing the vial from the puck, placing on a buffer table, and moving the vial from the buffer table to an empty tote OR moving a vial directly from a puck to an empty tote. A minimum of two robotic units are required for redundancy.

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Proposed Tote Marriage Area Configuration

The proposed tote marriage area configuration shows the following upgrades over the existing tote marriage layout:

Robotic de‐puck and vial accumulation sort tables utilizing a smaller footprint for tote marriage.

Marriage tote recirculation to provide the ability for totes to return to tote marriage if required.

Added Manual Unit of Use Dispense Stations prior to A‐Frame Dispense

Tote A‐Frame Recirculation to allow totes to return to Unit of Use dispensing without traveling the entire tote conveyor system within the APFS.

Added Tote Exception Stations to allow for the ability to perform corrective actions immediately after dispensing and prior to entry to tote labeling.

Added Puck Exception Station to allow for the ability to remove pucks that were mis‐ diverted to the tote marriage area.

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3.6. Tote Conveyor and A‐Frame

The tote conveyor includes the movement of totes through the tote marriage area, manual unit of use dispensing area and the recirculation loop for the tote marriage and manual unit of use areas. The conveyor will convey empty totes from pack stations and to tote marriage and the order start area.

All other tote conveyor connections are not included in this scope of effort.

3.6.1. Current Conveyor and A‐Frame

The current conveyor system routes empty totes to the tote marriage area. The totes can be diverted into one of two tote marriage lanes or pass through to the A‐frame modules. The totes pass through both A‐Frame modules and are sent on to tote labeling. The conveyor has the ability to bypass the first A‐Frame and divert into the second A‐frame, however the site has experienced issues with congestion at the diverts and has fixed the path to include both A‐frames.