CASE STUDY
www.swisslog.com
How Strong Memorial Hospital
Managed a Seamless Transition to
Next-Generation Pharmacy Automation
A PATIENT-FIRST APPROACH TO PHARMACY INNOVATION
Located in Rochester, New York, Strong Memorial Hospital is a prominent teaching hospital
affiliated with the University of Rochester Medical Center. The 886-bed facility serves
communities across Monroe County and nearby regions in Upstate New York and the Finger
Lakes. Strong provides a wide range of specialized services, including organ transplants, trauma
and burn care, cardiology, neuromedicine, neonatal intensive care, cancer treatment, and other
critical care services.
According to Claire Burke, assistant director of pharmacy operations at the University of
Rochester Medical Center, they embraced technology solutions early on to help manage this
volume. “We’ve always focused on automating processes as much as possible,” she says.
“To increase efficiency, but also to ensure patient safety by removing the risk of human error.”
According to a September 2025 article published by Research in Social and Administrative
Pharmacy, dispensing errors in pharmacies average 1.6% globally. In hospital settings —
interruptions and distractions account for 9.4% of these errors. Automation eliminates this risk.
That’s why the pharmacy uses both an ambient and refrigerated BoxPicker from Swisslog Healthcare
to automate the refilling of dispensing cabinets. They’ve also been using a PillPick from Swisslog
Healthcare for their patient-specific dispensing since 2009. “One of the unique things about the
PillPick robot is that it automates the entire process,” explains Burke. “It repackages medications
into unit doses from bulk containers and also dispenses them.” Achieving the same amount of
automation the PillPick delivers with a single robot would require a number of separate systems for
packaging, storage, and dispensing — each with its own maintenance and training overhead.
When their first PillPick began to reach its expected end of life, however, the pharmacy knew they
would need to replace it. “The robot just required more maintenance, some of the parts weren’t
even available anymore, and we were experiencing more frequent downtimes.”
THE CHALLENGE: UPDATING CRITICAL
AUTOMATION WITH NO PATIENT IMPACT
After doing some research on the latest technology on the market, Strong ultimately chose to stay
with Swisslog Healthcare’s solution. “We realized pretty quickly there was no other machine like
the PillPick that integrates unit dose repackaging and dispensing,” says Burke. “We felt moving
away from that functionality after 15 years would be too disruptive to our workflows.”
Claire Burke
Assistant Director of
Pharmacy Operations
~ University of Rochester
Medical Center
CASE STUDY
www.swisslog.com
Once Strong received budget approval for swapping out the legacy PillPick with a newer model,
Swisslog Healthcare assigned a seasoned project manager who specializes in workflow
optimization to help develop a transition plan that would minimize the impact on day-to-day
operations as much as possible.
THE PLANNING: A DATA-DRIVEN MANUAL WORKFLOW DESIGN
Swisslog Healthcare estimated that dismantling Strong’s existing PillPick and building the new
system would take approximately eight weeks from start to finish. “Our staff were pretty nervous
about the process because we all know how much work the robot does for us and how much we
rely on it,” Burke says. They already knew what even short periods of downtime were like. “Even if
the robot is unavailable for a shift or two because of maintenance, it’s still stressful.”
“I had to assure everyone that we would be extra prepared,” says Burke. To do that, she used
aggregated data from a number of systems used for medication management in the pharmacy
to estimate the volume of work that would be required to meet their commitments. This included
determining the number of doses dispensed, the time of day medications were dispensed,
and how long it took to dispense them. The purchasing team also evaluated all line items from
the robot inventory to identify which were available in commercial unit doses. The dedicated
pharmacy technicians for the robot then pre-packaged a five-month supply of unit doses for
medications that could only be purchased in bulk.
Estimating that the PillPick automates manual tasks about three times faster than manual
processes, Burke then used what she learned to determine the additional staffing needed to
replicate the robot’s tasks within the same timeframe, while maintaining the robot’s accuracy and
safety. This included:
• An extra pharmacist for the day shift.
• An extra pharmacy technician for the night shift.
• An extra robot technician (staff who were doing the work traditionally accomplished by the
robot) for both the day and evening shifts.
From there, Burke was able to make strategic, well-informed decisions on how to design manual
workflows and processes. This involved creating a mini-pharmacy in a large conference room
to manage manual dispensing, separate from their main pharmacy. They also mapped out what
drugs they needed to stock, and in what quantities, and explored using other technology, such as
barcode scanning, to make processes both efficient and secure.
The Swisslog Healthcare project manager assigned specifically to Strong Memorial helped them
anticipate any additional needs they might have during downtime. “For instance, we needed to
find space to store all the parts for the new machine so they would be onsite when Swisslog
Healthcare was ready to build the new PillPick.”
THE OUTCOME: EXCEEDING EXPECTATIONS THROUGH
PLANNING AND TEAMWORK
“The whole process went much better than we expected,” Burke says. “I think the preparation we
did set us up for success. Honestly, we may even have been overprepared.” That’s because they
purposely overstaffed initially to give pharmacists and pharmacy technicians time to become
accustomed to the process. “We didn’t want them to feel rushed or overworked.”
As anticipated, Strong’s pharmacy staff rose to the challenge. In fact, Burke reports that techs were
constantly coming up with new ideas to make processes even more efficient. “Picking drugs off the
“
We found there was
no other machine
like the Swisslog
Healthcare PillPick
that integrates unit
dose repackaging
and dispensing.”
Claire Burke
Assistant Director of
Pharmacy Operations
~ University of Rochester
Medical Center
CASE STUDY
www.swisslog.com
shelf, dispensing and managing inventory can be monotonous and pretty physical at times. So I’m
personally proud of how everyone kept a positive attitude and worked together to help make sure
everything went as smoothly as possible.”
LESSONS LEARNED: INSIGHTS FROM
A SEAMLESS TRANSITION
The process began in mid-July 2024, and the system was fully replaced and up and running by
November 11th. During the downtime, the Strong team dispensed 590,690 doses manually and
repackaged over 65,000 unit doses and capsules.
Burke says two things became clear to her right away. “The whole process made me appreciate the
value of project management and communication. The more planning you can do and the more you
can communicate with internal and external stakeholders upfront, the easier the transition will be.”
The experience also yielded an immediate ROI for Strong Memorial when PillPick replaced manual
work. “The extra shifts we had to add to manage the workload done by the PillPick meant paying
a lot of overtime,” says Burke. In addition, they had to buy some medications in commercial unit
doses that were typically purchased in bulk, which can sometimes be significantly more expensive.
“We’ve been using the PillPick for so long, I don’t think we fully appreciated the benefits that the
automation has on our bottom line,” says Burke. “Without this technology, we would be buying a
lot more unit-dose drugs. I’m not sure we ever quantified the savings before.” She goes on to say
that if they didn’t have the robot, they’d need more staffing to package and dispense medications.
“We wouldn’t be paying overtime, but we’d probably be pulling other full-time staff away from
their day-to-day activities to help,” she says. “Now those resources can spend time on other tasks
valuable to the pharmacy and hospital.”
Of course, for Strong — the primary focus has always been on patient safety. “Even if you have
a manual scanning process, if a human is doing it — a human can miss a scan,” Burke explains.
“You can dispense something without scanning it, or put something in the wrong bag even if it’s
been scanned, or dispense the wrong bag to the wrong patient. There’s a lot that can go wrong.”
The automation of the PillPick removes the points at which human error can introduce risk into
the process, says Burke. “In the numerous years we’ve been using the PillPick, it’s never once
dispensed the wrong medication.”
LOOKING AHEAD
Next, Strong will replace its refrigerated BoxPicker with a newer model. While that’s down the road
a bit, Burke says she’ll use the knowledge she gained from the PillPick project. In the meantime,
they’ll continue working with Swisslog Healthcare to improve their overall processes. “I’ve always
appreciated how willing Swisslog Healthcare is to take our experience from the frontline and try
to implement that into their solutions. They even sent someone to observe our transition process
and document what we were doing through the rebuild to help others in the future. It’s been a
great relationship over the years, and we really enjoy working with them.”
Strong’s experience highlights the value of thoughtful planning and collaboration in transforming
a high-risk transition into a model for pharmacy innovation. Since this experience, Swisslog
Healthcare has taken the learnings from its time with Strong Memorial to create additional
documentation and resources to help customers navigate equipment replacements in order to
ensure success and minimal workflow disruptions.
“
Our staff were pretty
nervous about the
process because we
all know how much
work the robot does
for us and how much
we rely on it.”
“
I've always
appreciated how
willing Swisslog
Healthcare is to take
our experience from
the frontline and try
to implement that
into their solutions
… we really enjoy
working with them.”
Claire Burke
Assistant Director of
Pharmacy Operations
~ University of Rochester
Medical Center
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