Thirteen years ago, when Pharmacy Purchasing & Products began conducting this survey, most medication orders arrived in the pharmacy via fax machine or courier; fewer than 3 out of 10 facilities had CPOE in place. Medication distribution was typically centralized in the pharmacy, but only half of hospital pharmacies had a unit dose packaging operation, and just 2 out of every 10 were verifying medications at the bedside. Temperatures in medication refrigerators were typically recorded manually on paper logs and a shocking number of facilities were purchasing their medication refrigerators at the local hardware store.
Continuing this effort, in the second quarter of 2019, PP&P polled a random, nationwide sample of health system pharmacy directors. We queried these pharmacy leaders as to their current expenditures on pharmacy automation as well as future budget projections. In addition, we asked about automation usage, staffing levels, and future automation expansion plans. Responses were solicited via email and a total of 260 pharmacy directors replied, yielding a confidence interval of 4.98 (90% +/-4.98) based on the population of pharmacy directors nationwide. The results of our survey are shared on the following pages.
We intentionally survey a random sample of pharmacy directors to ensure the data reflects trends across the entirety of US hospital pharmacy practice. Given this approach, we are pleased that 88% of pharmacy directors rely on PP&P when researching automation purchases.
Growth and Improvement
Rising automation budgets are supporting expansion in many areas within pharmacy; for example, this year has seen growth in the number of facilities that are purchasing automated drug storage and retrieval systems to support medication distribution, and more facilities are switching to medical grade refrigeration units while simultaneously automating temperature monitoring processes. As the challenge of sourcing medications in bar coded unit dose has yet to abate, an increasing number of facilities are looking to outsource at least some of their repackaging needs.
Pharmacy directors are looking to reap the financial benefits derived from outpatient pharmacy operations; more facilities are launching outpatient pharmacies and the services offered in this environment are expanding. Pharmacy directors are also leveraging newer technology options to improve operations: implementations of medication tray management systems and IV workflow management systems increased this year. The need to automate compounding processes is evidenced by the number of facilities considering IV robotics.
Some technologies are used widely, yet not to their fullest capacity. Smart pumps, for example, are ubiquitous and often linked directly to the BCMA system; however, a minority operate their smart pumps with bidirectional data transfer.
ADCs are similarly ubiquitous and most facilities have committed to bar code verification during the refill process, as well as monitoring software for diversion management. Nevertheless, most procedure areas continue to operate without the safety of specialized ADC systems.
Just as we cannot imagine not scanning medications at the bedside now—we must commit today to the automation that will become equally indispensable 10 years from now. Leveraging automation to address the safety risks inherent to the CSP process is today’s imperative. The technology exists; pharmacy must partner with industry to fine tune automation that ensures the safety and accuracy of the CSPs delivered to patients.
Deanne Halvorsen is the editorial director of Ridgewood Medical Media, publisher of Pharmacy Purchasing & Products and MedicalLab Management. She can be reached at firstname.lastname@example.org.
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