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Introduction to Automation

Learn more about the importance of automation in pharmacy practice.
Hello, everyone. My name is Shao-Chin Chiang. I’m currently the deputy director of pharmacy in Koo Foundation Sun Yet-Sen Cancer Center Taipei, Taiwan. Today, we are going to discuss a very important topic about pharmacy practice. And also it will affect current and the future practice of pharmacy. That is automation. Automation is currently use in lots of developed countries. It’s also very important issue in Taiwan. This is the outline of today’s content. Firstly, we will introduce what is technology and also automation is one of the technology we will explain what is the definition of automation. And also we want to tell you the purpose of automation, especially in pharmacy practice, and also automation very closely relate to patient safety.
And actually patient safety is actually our goal of automation. And also we will introduce available automation applications in pharmacy currently and probably we will focus on the inpatient pharmacy practice. And most important, the roles of pharmacy in automation we need to know. And also automation could impact on the Pharmacy Manpower currently and in the future. And then, lastly, we will have conclusion. So, what is technology? Technology is anything used to replace routine or repetitive tasks previously performed by people or to extend the capability of people. Pharmacist has been used technology for a long time. Because through the years, pharmacists, we need to pick the medications we verify orders and we prepare the unite dose system.
These are all labor-intensive and routine and repetitive tasks. So, it is a prerequisite to survival of the profession and the advancement of pharmacist patient care services. We would like to use automation so that those repetitive tasks could be done by the machines and the pharmacists, they have learned a lot knowledge about therapeutic, about pharmacokinetics, about drug reactions. These could be used to improve the patient care. So, what is automation? Automation is a type of technology, and it could be any machine or device linked to or controlled by a computer and used to do work. And also all automation is a form of technology but not all technology is automation. What is the purpose of automation?
Automation is to improve patient safety, enable professionals to provide high quality care and help patients make the most of their medicines. And also, automation should free pharmacists to provide patient care services to improve health outcomes. Automation could provide several benefits. For example, automation could enable routine, repetitive and monotonous tasks to be conducted with consistency. And also automation could standardize and also consistently use of terminology and nomenclature. And mass customization, which is the capacity of information technology to provide services to a large population, yet in a way that can be customized to the individual. So, these are the benefits currently the automation wants to reach. Actually, automation, the purpose and goal is to improve the patient safety.
Before we try to improve the patient safety, we need to know where is the high risk of errors in all the process of pharmacy service. According to Bates and his colleagues, they described four phases in the main medication use process, which are ordering, transcribing, dispensing, and administration. Among all these four phases, if we consider all preventable and potential adverse drug events. About 49% throughout the process, the errors are currently in the ordering phases. And about 26% current in the administrative phase. If we consider only the medication errors causing patient harm, then 90% of errors occurred during the ordering and administrative phases. Therefore, we know the ordering phases and administrative phases are the two phases has the highest risks of errors.
Data also suggests that technology along with automated systems aimed at improving ordering and administration in the medication-use process can have the greatest impact on patient safety in hospitals. so Because we want to prevent the errors occurred during the ordering process, currently, computerized prescriber order entry systems, which is also abbreviated a CPOE system, is probably the most common methodology of automation to prevent the errors in ordering phases. The CPOE system can assist the ordering phase. It could guide the prescribers through the order entry process, and also it could reduce the need to transcribe orders. In the CPOE system, the computer will provide all the necessary information of the drugs.
And also could include all the patients’ specific information together so the prescribers could look at both information and make decision on the use of medication. So, the prescriptions would have better results. Because the physicians of prescribers, they prepare and they save the prescriptions in electronic ways, so electronic data could be sending to the pharmacy. So, pharmacists, they do not need to transcript the order anymore, and transcribing is also the risks of errors. Bar code medication administration, we also abbreviate as BCMA technology, is probably currently the best way to improve the administration phase. In the BCMA technology, every tablet, every vial, every ampoule should have its own bar code on the products.
And nursing staff should scan the bar code on the products and also the patients’ name, the medication bar code on patient side, and also scan her own identification. So, this will ensure five rights of medication administration, which are the right patient, the right drugs, the right dose, the right route and the right time.

Shao-Chin Chiang explores the different aspects of automation in pharmacy practice, explaining what automation is, how it changes pharmacists’ jobs, and what pharmacists need to know about it. Chiang first outlines the learning objectives of this activity before going over the necessary terminologies.

Key Points on Automation in Pharmacy Practice

  • Technology: Anything used to replace routine or repetitive tasks previously performed by people or to extend the capability of people. Pharmacists have been using technology for a long time to verify orders and prepare the unite dose system more efficiently. Technology frees pharmacists to carry out other tasks that improve patient care.
  • Automation: A type of technology. Any machine or device linked to or controlled by a computer used to do work. All forms of automation are technology but not all technology is automation. The ultimate goal of automation is to improve patient safety.

Benefits of Automation in Pharmacy Practice

  • Improve patient safety
  • Enable professionals to provide high-quality care
  • Help patients make the most of their medicines
  • Free pharmacists to provide patient care services
  • Perform routine, repetitive, and monotonous tasks more consistently
  • Standardized use of terminology and nomenclature
  • Mass customization

Medication use process can be broken down into ordering, transcribing, dispensing, and administration phases. Data has suggested that applying technology and automated systems can aid to reduce errors in the process, especially in the ordering and administration phases.

Examples of such systems include:

  • CPOE system, which assists the ordering phase by eliminating the need to transcribe orders, and also provide prescribers with the necessary information.
  • BCMA technology, which improves the administration stage, ensuring the right patient receives the right drugs of the right dose via the right route and at the right time (5 Right policy).


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