The need to do more with less is driving automation in pharmacy, says Marta Stybowski, but are we asking the right questions?
The growing pressure to achieve more with less is seeing a steady growth in the adoption of a variety of automated technologies into pharmacy practice.
With a number of options available across the various operational areas of pharmacy, and varying global pharmacy market conditions, there are a number of aspects worth considering as part of the decision to invest and implement automation technology into a pharmacy business.
This article [an extract of a longer CPD-accredited article] will examine the types of automated systems available to pharmacy and how these systems can provide benefits to the business.
Some of the earliest automated systems were introduced into pharmacy in the US in the early 1970s and used to add efficiency to the mundane task of pill counting. The mainstream introduction of computers into community pharmacy in the 1980s assisted with a variety of operational functions, and a decade later full pack dispensing robots made their debut in Europe.
In addition to these examples, the progressive uptake of automated technology by both hospital and community pharmacies alike for close to five decades, has also seen advances in dose administration aid (DAA) packing, pharmacotherapy dosing as well as electronic prescription technology.
Types of automation
With the diversity of markets and dispensing trends, an equally diverse number of automated hardware and software solutions have been developed for pharmacy, with some examples including:6
- pill sorting and counting machines;
- pill packaging machines;
- full pack dispensing robots;
- pharmacotherapy automated dosing systems;
- dispensing cabinets and devices;
- automated compounding systems;
- inventory management—including virtual pill count systems for DAA preparation;
- medical history and patient database management;
- drug interaction checks;
- electronic prescription systems;
- remote-dispensing systems; and
- narcotic and controlled substance monitoring.
While it is not possible to examine all of these in detail within the scope of this article, we will look at some of the key automation categories with examples below.
Automated dispensing systems
Automated dispensing systems can be loosely grouped into two key categories; individual pill dispensing and full pack dispensing. The application of these systems is predominantly governed by prescribing and dispensing trends such as individual pill count dispensing in the US or predominantly full manufacturer pack dispensing here in Australia.
Automating the laborious task of pill counting adds efficiency to a process where medicines are dispensed from bulk quantities—with the tablets/capsules counted as per the individual prescription quantity. While mainstream in the US, this is similar to dispensing trends in New Zealand, with prescribed quantities varying and full pack dispensing being the exception rather than the norm. In these cases, automated pill counting machines or unit dose dispensers are beneficial with systems such as pill counters by Kirby Lester, Parata, and Yuyama.
The solutions available for this purpose, range from small counter top units designed to count quantities of an individual pill type, to larger units capable of storing a broad range of products—depending on the unit model, from a few dozen key lines to a couple of hundred lines. These systems interface to the dispensing software and deliver the required quantity of tablets into a vial, for labelling and supplying to the patient.
A different type of automated solution is used to add efficiency to dispensing where prescription quantities are based on manufacturer packs, such as we see here in Australia. There are two main types of robotic systems that suit this need; channel and chaotic units—with the name referring to the manner in which medicine packages are stored within the robot.
As the name implies, channel systems have a series of channels, where each channel is assigned to a particular product and stores multiples of that product. The design and engineering of channel systems means they often have a smaller footprint, and a fast picking speed; however, the range of SKUs stored in the unit is determined by the number of channels.
Automated packing systems
With an increasing ageing population, another area of automation experiencing growing popularity is unit dose packaging systems. These robotic systems are in use around the globe, with applications in the US and Europe, as well as here in Australia. The options for this type of automation include packaging patient dose regimes into a series of pouches or sachets, or blister cards typically configured in a four by seven arrangement, providing a week’s worth of doses for the patient.
Automating the laborious task of preparing patient DAA packs may add significant efficiency to managing this aspect of a pharmacy operation, particularly when coupled with automated verification systems that scan prepared pouches for potential mismatches that a pharmacist then checks. The systems are currently used in Australian community pharmacies, as well as designated DAA packing providers that pack on a behalf of pharmacies.
Benefits of automation
Undoubtedly, implementing automated systems into a pharmacy operation is done with the aim of improving efficiency—be that in the form of time, space or resource savings. The primary driving factor may differ in each case, with retail shopping centre pharmacies experiencing the pressure of rising tenancy rent costs, rural pharmacies struggling to balance growing demand for services with attracting staff resources, and hospital pharmacy departments working to KPIs based on patient through-put and inventory costs.
Evidence indicates that implementing automated dispensing systems achieves efficiency gains in the key areas of space, time and resources:
- prescription processing time—and therefore reduced patient wait times;
- staff resources—thereby freeing up valuable staff resources for other tasks; and
- reduction in stock holding—reducing inventory footprint and costs.
Click here to access the full, CPD-accredited, article
Marta Stybowski, BPharm, MBA, Cert IV TAE, MPS, is General Manager of Pharmacium