Automation in

practice

January 7, 2017

level (3) - lectrue (7)

Introduction

Today, patients demand high quality,

efficient, and cost effective service.

Use of efficient technology to provide

quality service.

Automation is designed to streamline

and improve the accuracy and efficiency
of the medication use process.
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Introduction

Automation

Any technology, machine or device linked

to or controlled by computer and used to
do work such dispensing, recognizing
adverse drug events and interaction,
etc
Automation in pharmacy practice such as
dispensing began in the early 1960s , and
since it offers great potential in pharmacy
practice. To realize the full benefits of the
potential inherent in automation systems,
it is necessary to understand basic
concepts of automation.
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Why pharmacy
automation?

increasing and demand for automation due

to dramatic change in heath care system
and professions transition to
pharmaceutical care.
(As the profession has accepted increased
responsibility for improving patient
outcomes through implementation of
pharmacist patient care services )
Shortages of qualified pharmacists and
technicians
Shrinking operating budgets
Freeing pharmacists to review medications
prior to administration reduce medication
errors.

Goals and advantages

Advantages:

Limits or eliminate personnel overtime

Reduces medication errors and improve accuracy
Improves documentation
Improve efficiency and control cost
Increase medication safety
Increase production, decrease operating cost
Reduces large manual prescription filling
workload
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Reduce job stress and staff turnover

Introduction :

Primary drivers of this trend

(automation)

Reducing cost
Improve operating efficiencies
Growing revenues
Enhance the safety and quality
Providing an outstanding customer services
Shortages of qualified pharmacist and tech.
Shrinking operating budget
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Strategies for
automation

Pharmacy Automation address issues such as:

Storage, packaging and pickup
Dispensing
Drug delivery systems such as infusion
pump
Distribution of medications
Electronic data transfer
Maintenance of transaction information.
Medication use process which consists of:
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The medication-use
process :

The medication use process consist

of five domains
Purchasing / inventory management
Prescribing / medication determination
Medication preparation / dispensing /
counseling
4. Medication administration
5. Patient monitoring / assessment
1.
2.
3.

Strategies for
automation :
Drug distribution and dispensing systems:
1. Centralized robotic for dispensing
medication:
Centrally located automated dispensing
devices are designed to automate the entire
process of medication storage , dispensing,
re-stocking, and crediting of unit dose
medication
Bar coding of medication doses allows
dispensing accuracy to approaches 100%
with centralized robotic technology
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Strategies for
automation :

Potential advantages of robotic

systems includes
Reducing pharmacy labor cost
Eliminate technical task of pharmacists
to facilitate performing clinical activities
Improving medication dispensing
accuracy
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Centralized robotic

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Work Flow Planning for

Efficiency Pharmacy
Process Order
(Validate Med)

Visits
Provi
der

Patie
nt

Yes
Pharmacy
Need Provider
Receives order Approval

Intervene

s
Ye

NO

Send to
Automation
Provider input
prescription order into
the system

Manual Fill

Pharmacist Check Prescription (Validation of

and Product Filled)
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Work Flow Planning for Efficiency

Pharmacy
No
Checks the Five
Rights

Patient Visits
Provider

Yes

Intervene

Administer to
Patient

Sends to Nurse
Pharmacist Checks and
Fills Order
Provider input
prescription order into
the system

Patient Reaches

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Strategies for
automation :
2. Decentralized automated dispensing device
Refer as unit-base dispensing cabinets
Are secure storage cabinets capable of handling
most unit-dose and some bulk medication
to provide prompt , real-time availability of medication
for the nurse and patient,
to control over controlled substances and floor stock
medication and pharmacy and nursing labor cost
Limitation of this system
Nurse retrieving an incorrect medication because of
open access to all drug in drawer
Drug stock in the wrong pocket
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Changing location can cause error

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Strategies for
automation :
Drug administration systems:
The most error-prone phase
BCMA technology can help dramatically
reduce these error
BCMA enable a nurse to administer
medication and help to ensure the 5
rights of medication administration

Right patient
Right medication
Right dose
Right time
Right route

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Strategies for
automation :
Major limitation to implementing BCMA
includes:
Cost of the BCMA software
Cost of the BCMA-related hardware such as
portable scanning devices, bar code
printing system, bedside computer
All medication must be bar coded in unit of
use packaging to achieve optimal patient
safety
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Strategies for
automation :

Technology and automated devices applied

throughout the medication-use process :
Prescribing
CPOE
Dispensing
robotic dispensing
technology
Administration
BCMA
Monitoring
electronic clinical
documentation systems
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Automated medication
dispensing devices :

Automated dispensing systems are drug

storage devices or cabinets that
electronically dispense medications in a
controlled fashion and track medication use
Their principal advantage lies in permitting
nurses to obtain medications for inpatients
at the point of use
Most systems require user identifiers and
passwords
These automated dispensing systems can
be stocked by centralized or decentralized
pharmacies
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Automated medication
dispensing devices :

The invention and production of these

devices brought hopes of
Reduced rates of medication errors
Increased efficiency for pharmacy and
nursing staff
Ready availability of medications where
they are most often used (the nursing
unit or inpatient ward)
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Future role of pharmacy

personnel as a result of
automation :

The transformation of the pharmacist role

from distributor of drug to cognitive provider
of care has largely resulted from pharmacist
access to patient specific information about
diagnose, lab result, treatment progress, and
patient entire drug therapy regimen
Integrated delivery system and automation
will continue to provide pharmacist with
opportunity to work more closely with
physicians and patients to assure appropriate
drug therapy decision and outcomes
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Future role of pharmacy

personnel as a result of
automation :

Pharmacist must continue to assume increased

responsibility for understanding patient drugrelated needs, identifying, resolve and
preventing drug-related problems
Clinical pharmacist in the virtual world may have
3 primary responsibilities
To assess patient compliance and medication related
outcomes
drug and disease education
Intervention

The optimization of such role is essential in both

inpatient and ambulatory environment to avoid
displacement of pharmacists by automation 22

Summary :

Automation is not a panacea

Optimized use of automation to perform
distributive functions currently performed
by pharmacists and technicians is essentials
in providing pharmacist with additional time
to take care of patients in the future
Efficient electronic physician prescribing
system, fully automated dispensing system
and virtual patient monitoring system will
be commonplace in the medication use
process of the future
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Definitions :

Automation
Bar code medication administration-BCMA
Computerized prescriper order entry-CPOE
Adverse drug event
Medication error
Inventory control
Controlled substance
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