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In the early summer of 2008, PP&P polled a random, nationwide sampling of health system directors of pharmacy. We asked about their facilities, their current automation systems, their satisfaction with those systems, and their plans to implement new automation systems in the near future. Responses were solicited via mail and e-mail, and we received a total of 376 responses, yielding a confidence interval of 4.87 (95% +/-4.87) based on the total population of directors of pharmacy nationwide.
We intentionally surveyed a random sampling of directors of pharmacy, not just readers of Pharmacy Purchasing & Products, to better capture data that reflects trends across the whole of hospital pharmacy practice. Therefore, we were quite pleased to see that 71% of survey respondents report using PP&P as a tool for researching automation purchases (See Figure 1).
With 2008 being the third year of this survey, many trends are becoming quite clear.
The big story this year is the strong move toward implementing sophisticated technology solutions. No longer are most facilities in a ‘let’s wait and see how the technology evolves’ mode when it comes to automation solutions like bar coded medication administration (BCMA), computerized prescriber order entry (CPOE), and smart pumps. Rather, the vast majority of hospitals now take for granted that they will implement these technologies and are in the first stages of doing so. There is also a clear recognition that these implementations are complex and will not happen overnight. Many of these implementations are projected to take a few years to complete.
While the largest hospitals continue to have the highest implementation rates and obviously the highest budgets, many smaller hospitals are also making inroads in adopting more sophisticated automation systems.
In the midst of this strong move toward big-ticket implementations, DoPs are not overlooking the straightforward automation solutions that are also available, such as wireless temperature monitoring systems and automated medication reconciliation systems. Not only were adoptions up this year for these automated solutions, but that growth is also predicted to continue into the near future.
Preparing for Automation Implementations
In recognition of the growing demands from these new technology implementations, we have seen an increase in the support structures necessary to complete these implementations. The number of designated pharmacy informaticists on staff is growing, and we predict that facilities with these dedicated specialists on board will soon be in the majority. The cost of adopting more sophisticated technology is reflected in increasing automation budgets. Not only were significant budget increases reported during 2008, but that trend is also projected to continue.
(See Figure 2).
Necessary infrastructure improvements are also in the works. A growing number of facilities are implementing wireless networks to support their technology adoptions. Wireless networks now enjoy broad adoption rates, even among smaller hospitals. Two-dimensional bar codes have moved into the mainstream, and packaging in bar coded unit dose is practically taken for granted, with the majority now doing so.
Drug distribution methods are also changing to support the move toward more sophisticated technologies. The trend toward hybrid and decentralized distribution methods is continuing. And when it comes to method for distributing medications, the more sophisticated products, such as ADCs, COWs, and in-room medication cabinets win out.
The majority of hospitals are now packaging their medications in unit dose, bar code packaging. Given that 81% of hospitals are projected to be packaging their medications thus in the next few years, hospital pharmacies are committed to repackaging medications, although they are simultaneously looking for approaches to do so more efficiently, and with fewer FTEs.
Key Technology Solutions
In addition to measuring what systems are currently in place, we asked DoPs to rate the five technologies that are most important to their organizations. (See Figure 3). The solutions, in order of their importance, are:
1. Automated Dispensing Cabinets
2. Bar Coded Medication Administration Systems
3. Bar Coded, Unit Dose Packaging Systems
4. Smart Pumps
In comparison to last year, BCMA’s importance grew and surpassed unit dose bar code packaging to take the second place spot. Other product classes that showed increases in importance over last year were smart pumps, CPOE, wireless temperature monitoring systems, and automated compounding devices.
Top Rated Automation Solutions
User satisfaction rates rose this year, reflecting both maturing technologies and increasing user expertise. We compared satisfaction rates for each class of automation products, and are happy to report that the top five product classes DoPs are most satisfied with are:
1. Automated Compounding Devices
2. Bar Coded Medication Administration
3. Carousel and Robot Storage and Retrieval Systems
4. Automated Dispensing Cabinets
5. Smart Pumps
This list of top-rated solutions is made up of very diverse technologies, from automated compounding devices, which are implemented primarily in larger facilities, to automated dispensing cabinets, which enjoy widespread usage across facilities of all sizes.
Pharmacists as Decision-Makers
Another trend showing sustained, positive growth is the level of pharmacist involvement in purchasing decision-making and technology implementation. We are pleased to report that this involvement has grown in many areas, including smart pumps, BCMA, ADCs, and bar code printers.
There is no shortage of well-rated products available for increasing pharmacy automation. In fact, many of the products that made the top-rated solutions list also made the key technology list and the list of products where pharmacy noted increasing purchasing involvement. The key next steps are to get involved in product selection and stay informed. Use PP&P# as a resource for product reviews, purchasing checklists, and case studies, and use www.findit.pppmag.com as a tool to contact vendors for further information.
And perhaps, next year you can reap the benefits of your increased automation with an extended vacation.
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