Joel Arun Sursas Reviews Healthcare in the Age of the Automated Pharmacy

Pharmacies bridge the gap between healthcare providers and the pharmaceutical industry, serving an essential function in the health sector, especially when it comes to ensuring and elevating patient care. Pharmacists oversee medical dispensing, a painstakingly time-consuming and tedious process, but necessary to provide patients with the appropriate medication without error. Despite the current manual systems in place and the hard work of individuals, the occasional blunders do occur as a result of human miscalculation. Unfortunately, a single glitch in the medical system may prove fatal [4]. With the increasing world population and rising demand for affordable yet reliable healthcare, now, more than ever is the industry in dire need of innovation.

The idea of pharmacy automation isn’t exactly new and has been around as early as the 1960s [5]. Automation, in general, can help reduce human error and enable pharmacists and technicians to make better use of their time and focus more on patients. However, only in recent years has technology advanced in a vast array of areas such as hardware, robotics, machine learning, and even artificial intelligence presenting automation as a viable solution to one of healthcare’s modern problems.

In this article, Joel Arun Sursas, Medical Doctor and Health Informatician, examines the benefits of such technological solutions and assesses the potential risks as well as the impact of robotic medication dispensing on staff productivity and patient medication adherence.

Types of Automation

During the late 1980s, hospitals introduced Automated Dispensing Cabinets (ADCs) [3]. In retrospect, these models are somewhat archaic, but they were the first medication distribution systems that relied on computers to manage storage, dispensing, and drug tracking. Although the initial adoption rates were minimal, it was an integral first step towards the future.

Pharmacy automation has yet to become standardized in today’s world, and as such, various manufacturers employ unique methods and approaches that go beyond dispensing. There is no one size fits all [4].

Some of the more common types of automation include [5]:

  • Automated phone calls informing patients their prescriptions are ready for pick up.
  • Pill counting and labeling.
  • Inventory management.
  • Informing physician’s when refills or clarifications are needed.
  • Tracking medication use.
  • Identifying an improper mix of medications before it becomes dangerous.

Since 2008, 80% of hospitals in the United States have implemented a version of an ADC to replace the traditional stock systems and medication carts in an effort to reduce manual workflows [3].

Benefits

Upheaving tried and true workflows that have been in place for decades doesn’t create a sunny disposition for every one. Still, as more data is collected, the benefits of pharmaceutical automation become clear. Even old guards may feel inclined to embrace change.

First and foremost, Automated Dispensing Machines (ADMs) or ADCs provide convenience to both the medical provider as well as the patient. Machines installed on the site of patient care drastically increases the number and types of drugs available, which can prove crucial during emergency situations during pharmacy after hours [2]. Furthermore, it allows the physicians to explain the medication and proper use of in-person and answer any questions.

Each year medication theft results in millions of dollars of damages [6]. Thankfully, ADMs not only provide security but electronic tracking as well. This helps ensure medication, especially narcotics, don’t mysteriously disappear. Moreso, if the ADM has point-of-care bar-coding capabilities, it ensures an electronic match between the patient and the prescribed medication. Such a system helps prevent misadministration and can proactively track drug usage patterns. It also improves accuracy, which is a major concern since even the most skilled are prone to human error [3]. ADMs have pinpoint precision, thus significantly reducing the chances of error during the measuring process. As a result, waste or unused doses are drastically reduced as well.

Lastly, ADMs improve inventory management and decrease dispensing time by utilizing pre-established computer software guidelines. Consequently, pharmacies can fill more orders and focus more of their attention on patient interaction [2].

Caution & Guidelines

Even though automation technology reduces human error in the pharmacy overall, it potentially opens new doors that should not be overlooked. Some of the concerns associated with ADMs include software glitches, misuse of overrides functions, improper stocking procedures if bar-coding tech is not activated, and substandard medication management services if a pharmacist is not present to advise patients and oversee prescription dispensing to help prevent error or unintended outcomes [5].

Therefore, it’s recommended to review and incorporate the following guidelines and practices [1]:

  • Sync the ADC to a computer via a reliable connection so that a pharmacist can review new medication orders and check the patient’s shared medical history to ensure proper dosage and rule out any allergic reactions, contradictions or potentially harmful drug interactions.
  • While cost may be an issue, it’s best to install a sufficient number of ADMs throughout medical care units to help maintain supplies and avoid early removal.
  • Avoid returning unused doses to the ADMs and use a double-check system such as bar-coding before medications dispense.

These, of course, are only a few of the guidelines medical providers and pharmacies should take into account.

Outlook

As with any automation fueled by technology, loss of human employment is of great concern. However, despite this common fear, pharmacies are evolving their business model and effectively allocating their current personnel to focus on care management. NCPA, APhA, and the Academy of Managed Care Pharmacy have all thrown their support behind dispensing prescriptions to patients as safely, quickly, accurately, and cheaply as possible [4].

As scientists and engineers make profound strides in the exhilarating frontiers of robotics, AI and machine learning, so too will pharmacy automation grow and improve. By implementing these emerging developments, pharmacies will become more personal, efficient, and safer.

About Joel Arun Sursas: Joel Arun Sursas is a Medical Doctor and Health Informatician motivated to solve administrative problems in healthcare. His determination to work tirelessly to bridge the gap between doctors and engineers is resulting in medical technology solutions that improve patient outcomes, enhance monitoring, and protect patient privacy. Dr. Joel Arun Sursas is an effective communicator who facilitates the achievement of team goals.

References

  1. National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP), Recommendations to Enhance Accuracy of Dispensing Medications, June 1, 2015. Retrieved from https://www.nccmerp.org/recommendations-enhance-accuracy-dispensing-medications
  2. Fung,E.; Leung, B.; Do Automated Dispensing Machines Improve Patient Safety? The Canadia Journal of Hospital Pharmacy, 2009. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827025/
  3. Grissinger, M., Safeguards for Using and designing automated dispensing cabinets. P&T Journal, 2012. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462599/
  4. Gebhart, F., The Future of Pharmacy Automation, July 4, 2019. Retrieved from https://www.drugtopics.com/automation/future-pharmacy-automation
  5. Chilcott, M., The Growing Trend Of Pharmacy Automation, November 7, 2018. Retrieved from https://www.forbes.com/sites/forbestechcouncil/2018/11/07/the-growing-trend-of-pharmacy-automation/#1031452267ca
  6. National Neighborhood Watch, Medication Theft: Protecting Our Most Vulnerable Neighbors, 2020. Retrieved from https://www.nnw.org/publication/medication-theft-protecting-our-most-vulnerable-neighbors

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