Not only do most hospitals not offer 24-hour pharmacy services, but a majority of those without round-the-clock coverage also do not have a plan to implement the service. The disparity between small and large hospitals, in terms of implementation, was striking: While 82.6% of respondents from hospitals with more than 500 beds claimed to offer 24-hour pharmacy service, only 8.3% of respondents from hospitals with less than 100 beds had such coverage.

In an open-ended answer, a number of survey participants described their methods for using automation to provide 24-hour pharmacy services. A majority of these respondents indicated using a hybrid approach, utilizing medication order management systems like Omnicell's OmniLinkRx and Pyxis Connect (which can be accessed from off-site computers by on-call pharmacists) to profile orders and automated dispensing cabinets to dispense medications. Other respondents indicated using services like Cardinal Health's Rxe-source to provide 24-hour pharmacy coverage.