Survey Design

In the early summer of 2009, Pharmacy Purchasing & Products polled a random, nationwide sampling of health system directors of pharmacy. We asked about their staffing, budgets, current automation systems, and plans for future implementations. Responses were solicited via e-mail, and we received a total of 396, yielding a confidence interval of 4.75 (95% +/- 4.75) based on the total population of directors of pharmacy nationwide.

We intentionally surveyed a random sampling of directors of pharmacy, not just readers of PP&P, to ensure our data reflects trends across the whole of hospital pharmacy practice. Therefore, we are quite pleased to see that 72% of survey respondents use PP&P as a tool for researching automation purchases.

Budget Crunch

Overall, pharmacy budgets remained flat versus last year, and while some of the smallest facilities enjoyed budget growth, 28% of all hospitals had budgets cuts. Only one third of facilities are expecting budgets increases next year, with the remainder projecting that their budgets will either stay the same or decrease. However, the long-term outlook shows signs of improvement: 59% expect budget increases in the next three to five years. 

Survey Trends

Despite the overall lack of budget growth, pharmacy continues to move toward automating manual systems, however at slower rates of adoption than previously predicted now that DoPs have to spread fewer dollars over multiple implementations. For example, with medication ordering, both physician order management systems and CPOE usage increased this year and more hospitals plan to implement these automated ordering systems in the next few years. In fact, more facilities are currently planning to adopt CPOE than ever before, however the timelines to adoption of these systems is now longer than originally predicted in 2008.

2009 also saw a leveling off of activity in the unit-dose packaging arena—fewer facilities outsourced their packaging and there was no increase in the number of facilities with packaging operations.  This slowdown in activity is expected to be temporary as DoPs looking forward predict there will be an upswing in both the use of outsourced packaging services and implementation of in-house packaging operations.

The move toward decentralized distribution models continues across facilities of all sizes, with the decentralized approach expected to surpass centralized as the most common distribution model in the next year. Reflecting this trend, COW usage is on the rise and there is a simultaneous uptick in interest in automated dispensing cabinets (ADCs).

While ADC implementations increased at a slower pace this year, this technology remains a favorite with DoPs. ADCs receive high user satisfaction ratings and with the exception of the smallest hospitals are used consistently across facilities of all sizes. 

BCMA adoptions continued to grow at a strong rate and interestingly, projected timeframes to implementation have not slowed. Pharmacy’s high level of involvement in selecting and implementing these systems is a contributing factor to their high user satisfaction ratings. Other technologies benefitting from increasing numbers of implementations include smart pumps and wireless temperature monitoring. Furthermore, strong growth for both of these classes is expected over the next few years.

The market segment experiencing the highest rate of growth this year is outpatient pharmacy. Given the positive impact outpatient pharmacy services can have on a health system’s bottom line, it is no surprise that many health systems are committed to incorporating outpatient services.