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Pharmacy continues to face two conflicting problems: The ageing of our population and the shortage of pharmacists. These issues lead to the inevitable result of pharmacists being forced to fill more prescriptions in less time. How can we improve our pharmacies' (and pharmacists') output, their productivity and efficiency, without the increased workload leading to an increase in dispensing errors and diminished patient safety? One of the answers can be found in the growing popularity of pharmacy automation.
Automation performs repetitive processes, frees people from routine tasks and has advanced tremendously since the late 1960's when a few counter-top systems were introduced. At first only affordable in the highest volume stores, we now see automation of all levels of complexity at a price any pharmacy can afford.
While pharmacy automation systems differ in complexity, they all decrease dispensing errors and reduce the time it takes to fill prescriptions. This can result in many corollary benefits, including lower dispensing costs, more free time for pharmacy staff, decreased waiting times and more time for patient counselling (which increases patient adherence, satisfaction and loyalty), and increased revenue due to higher efficiency.
Because one of the basic benefits of automation is error reduction, the first levels recommended to pharmacists are systems that impact the maximum number of prescriptions. The three basic systems are:
1. A barcode driven universal (or counter-top) counting machine combined with an electronic balance. This unit can be used to count all oral-solid medications quickly, accurately and without cross-contamination as well as for fast, accurate compounding.
2. A barcode-driven electronic water dispensing system for antibiotic products.
3. A telephone refill management system to answer all incoming phone calls (processing routine requests, including refills) while automating and managing much of the patient-pharmacist-physician communication.
With these three systems in place every prescription - new and refill - is affected by automation and the benefits of bar coding. These systems are affordable to pharmacies filling fairly low volumes (less than 100 prescriptions a day) given a return on investment (ROI) of less than 24 months. Additional automation systems may be added to higher-volume dispensaries, or as prescription volumes grow. These include:
· Semi-automated counting systems sometimes referred to as cassette or canister systems. These systems increase the amount of time saved per prescription handled, but they only affect a limited number of (high-volume) products - the number placed in cassettes.
· Full automation or cell systems: these further improve timesaving but are also limited to the pharmacy's highest-volume products.
· Robotics: this equipment saves the most time, but is usually reserved for high-volume pharmacies or for refill businesses.
· Workflow software, which manages the flow of prescriptions through the filling and verification process and efficiently operates the counting technologies mentioned above.
If and when these products are cost-justified depends on many factors unique to your practice. A competent pharmacy consulting firm will have the tools available to assist you in evaluating your needs to determine the best fit.
To ascertain which, if any, system suits your practice you should: 1) obtain a printout of your most-dispensed (100-200) products sorted by number of prescriptions and showing total volume dispensed; 2) determine the minimum, maximum and peak hourly prescription volumes; minimum and maximum staffing levels plus wages and benefits; pharmacist involvement in dispensing (percentage of each of active counting, oral antibiotic preparation and phone calls handled); 3) consult with one or more experienced companies who can help you analyze how automation will affect your practice and impact patient safety. Review all proposals and ROI projections carefully, looking for hidden assumptions that may not apply to your practice.
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