There are a few hospitals in the U.S. that are exceptionally automated. From the moment a patient enters the hospital, nearly every workflow is pristine, with each interaction electronically and securely captured with accurate and consistent information.
Many of these hospitals are acknowledged for their progress in Hospital & Health Networks’ annual Most Wired Hospitals survey. Then there are those that are operating without any pharmacy automation at all. In about 15 percent of hospitals, business processes and information-sharing methods have not changed since the 1970s, and the hospitals have no plans in place to evolve. However, the majority (about 85 percent) of the 5,700 U.S. hospitals has stepped into the 21st Century and at least partially automated their processes.
Obstacles to Expanding Automation
There is still work to be done to take automation to the next level but obstacles persist.
Perhaps the biggest obstacle to expanding automation and technology in the pharmacy is lack of capital. Expenses on the front end are high, as they are dedicated to equipment purchases and costs required for an install.
Another obstacle is the general reluctance to move forward due to the “pain of change.” Successful adoption of new technology often requires redeployment of labor resources and a redesign of workflows. To identify and optimize those changes requires creative and critical thinking.
Most hospitals have automated dispensing cabinets (ADC) in patient care areas. However, they could take their cabinet functionality to the next level with more advanced medication dispensing technology by including software to streamline medication use workflows, such as Omnicell’s Anywhere RN, which helps nurses manage medications remotely, away from the dispensing cabinet.
Some hospitals have implemented an analytics tool such as Pandora to help monitor clinical and financial aspects of a hospital pharmacy’s dispensing process with dashboards and drill down reports to monitor potential drug diversion (clinical) and optimize inventory management (financial).
To get to the next level in automation, hospitals can look to expand to the central pharmacy with carousel or robot technology. Ideally these systems should integrate with the automation used in the nursing units.
The ability to integrate automation technology with other information systems—including with wholesalers for electronic inventory ordering, and the electronic health record to streamline information related to dispensing, formulary management, charging/billing, and patient movement (Admit, Discharge, Transfers)—creates even greater opportunity for improving efficiency in the central pharmacy and nursing units.
Analyzing Current Processes
To move forward with the implementation or expansion of pharmacy automation and technology, hospitals should perform an analysis of their current state. Every step of the process must be looked at including:
- Order entry by a prescriber
- Verification of an order by a pharmacist
- Dispensing of the medication by a pharmacist or an automatic dispensing cabinet
- Administration of the medication by a nurse
- The monitoring of the effect of the drug on the patient
Is there an electronic or automated solution that can add value (i.e. increase patient safety) to any step of the hospital’s med use process? Can waste and redundancy be reduced or eliminated? Potential for medication errors reduced? When looking to level-up your automation, remember that it’s critical to not only optimize the technology, but the processes and personnel as well.
When it comes to medication use automation, what areas in your pharmacy workflow could be improved?