Omnicell’s Paul O’Hanlon on automation as the future of pharmacy and its potential to combat the current challenges faced in healthcare.
Medication costs are rising at a startling rate, there is further scrutiny on controlled substance use and medication non-adherence is taking a toll on healthcare costs and patient outcomes. Meanwhile, nursing and pharmacy staff are often trapped performing repetitive and administrative tasks that keep them away from patient care. However, industry pioneers see a solution.
The ‘autonomous pharmacy’ is a real and attainable vision for the future of digital medication management. It will combat challenges faced in healthcare today because manual, error-prone activities will be replaced by efficient, automated processes. Industry leaders are already making inroads towards this vision with a combination of advanced automation, data intelligence and service solutions. However, automation alone is not enough. The data from the automated systems must be harnessed to deliver intelligent insights and drive innovation in healthcare.
This ambitious vision comes in the wake of a report by the Department of Health & Social Care in 2018 which disclosed that in England 237 million mistakes occur every year at some point in the medication process. These errors cause serious issues for patient safety, but also place a significant cost burden on an already stretched NHS. The estimated costs to the NHS of avoidable adverse drug reactions is £98.5 million per year, consuming 181,626 bed days, causing 712 deaths and contributing to a further 1,078 deaths. The ongoing COVID19 pandemic has also demonstrated how automation within a hospital setting is a major asset in terms of safety and efficiency.
Fundamentally, a fully automated pharmacy would mean that medication management errors and their grave consequences would be eradicated, driving lower costs and increased safety. As a result, pharmacists and other healthcare providers could realise the full scope of their roles by spending more time on the most important thing, which is direct patient care.
The Impact of Slow Technology Adoption
A 2019 survey found that shockingly, 87% of pharmacists believe that the pharmacy profession has been slow to adopt new technology. This is damning, particularly when you consider that other technological innovations such as Artificial Intelligence and virtual care have been making waves in the healthcare sector. Pharmacy has been lagging behind somewhat and this is due to inadequate investment, an overdependence on manual processes and siloed technology.
There are six key risk areas for medicines in healthcare all managed by completely separate systems with some performed manually. These areas are prescribing, monitoring & review; administration; transfer of care; supply, storage & disposal; workforce capacity & competence; reporting & learning from incidents. As the Department of Health & Social Care’s report shows, due to such practices many medication errors are still reported resulting in severe patient harm, health deterioration and in the worst-case scenario, death. And yet, technology exists that practically eradicates all these issues.
The survey of pharmacists provided an overriding consensus that the autonomous pharmacy could improve patient care and care home services. Indeed, 73% of pharmacists feel that there should be an increased focus on technology and automation on the National Pharmacy Agenda. A more automated pharmacy would, therefore, enable a move away from time spent on manual drug distribution to a more patient-centric model with a focus on direct patient care.
Delivering the future of digital medication management
The autonomous pharmacy will combat the challenges faced by pharmacists and healthcare practitioners every day while trying to deliver quality patient care. In recent years, more and more administrative tasks have been added to the workload of healthcare providers while the number of pharmacists and support staff has stagnated. This takes significant time away from face-to-face interaction with patients and puts pressure on the already stretched NHS. This coupled with the UK’s aging population requiring increasingly more complex medication routines provides the perfect storm for mistakes in medication administration.
With the autonomous pharmacy, pharmacists will be freed from time-consuming administrative responsibilities, allowing for more time spent with patients. In hospitals, care homes and at the patients’ own homes medications will be sorted, picked, labelled, and reconciled at every point of use by the technology, much reducing any risk of error. It will all be powered by a connected pharmacy cloud infrastructure that will transform the healthcare environment by providing real-time data insights and predictive analytics.
We need a co-ordinated approach from industry leaders in order for such advancements in technology to be rolled out, enabling improved clinical decisions and more face to face patient care. The evolved autonomous pharmacy system will be able to predict and eliminate medication errors and waste before they happen, saving lives and money. Furthermore, this technology would allow every dose of medication to include contextual data about the destination patient, inventory, utilisation, the prescribing healthcare provider and more, all of which would be saved to the pharmacy cloud network. Healthcare providers can use the automated network to ensure that the right dose of medication is given to the right patient at the right time. This equals better health outcomes for patients and a more efficient system for staff.
A strategic concept for the future
There are certain key areas in which the autonomous pharmacy will ensure prime performance, and these are safety, finance, efficiency, regulatory compliance and people.
It has been found that poor systems and processes that are not in sync lead to human error – health systems dispensing more than 5m doses of medication will experience 25,000 mistakes annually. A robust, integrated system with automated medication management systems and processes will help protect patients across the care sector. Soaring healthcare costs would also plateau with such technology due to a reduction in error and more effective stock management.
The healthcare system also suffers from inefficiency. There is a huge reliance on manual labour for medication management which sees highly trained nurses and pharmacists responsible for ordering, verifying, retrieving, mixing, counting and dispensing medications. Combined with a lack of centralised data and thorough drug tracking, time is wasted searching for data and it is harder to predict and manage medication shortages. The autonomous pharmacy would take on all elements of medication logistics, reducing errors and confusion and freeing up more time for healthcare providers. This advanced system would also be able to complete and document all the necessary tasks and processes required for regulatory compliance, meaning it would not fall to highly trained medical professionals to complete by hand.
Finally, medication management systems affect many people, from patients to medical professionals to healthcare organisations. Time wasted on manual drug distribution and dealing with the consequences of dispensing errors can increase burnout, dissatisfaction and stress among healthcare providers and adversely impacts clinical outcomes. With the autonomous pharmacy, health systems are able to welcome a more patient-focused pharmacy model, consequentially leading to higher patient and staff satisfaction.
From this it is clear that when medication management processes are fully automated, data is used effectively to provide actionable information. Automation is not a replacement for humans, but a replacement for human error. It will lead to a redistribution of human talent to where it matters, patient care.
There are five key components that industry leaders see working in tandem to make up the autonomous pharmacy model: Enterprise structure, IT infrastructure, automation, data intelligence and human activity.
Pharmacy is not confined to the acute care setting. The enterprise structure of a truly autonomous pharmacy would have fully integrated automated technologies across all sites of care: inpatient, community/retail pharmacy and any other settings. This requires seamless integration of information and technology.
IT infrastructure is the heart of the Autonomous Pharmacy. It provides the entire collection of networks, data centres, facilities and equipment used to develop, test, operate, monitor, manage and support IT services in pharmacy. Once this infrastructure has transferred to a cloud-based platform, full integration will have occurred. This decreases administrator effort to find data and maintain the system, meaning fewer opportunities for error.
For full success in automation, manual labour needs to be completely removed from the workflow. Hardware and software technologies will be inputted that automate previously manual medication management processes.
Data intelligence refers to a system’s ability to centralise, standardise and automate data collection and reporting for maximum operational visibility. Organisations can then use data to analyse their operations and workforce to make better real-time decisions and facilitate process improvements. In the autonomous pharmacy, data visibility equals real-time workflow optimisation and predictive intelligence.
Human activity is put to much more efficient use after the installation of the autonomous pharmacy. Healthcare providers can realise the full scope of their roles thanks to processes prone to human error are transferred over to the system.
The autonomous pharmacy framework
The autonomous pharmacy is undoubtedly an ambitious vision for the future. Every day, leaders in the sector are advancing more and more towards full automation. The UK must follow in the footsteps of the US, where there are five levels of progress in which organisations should aim to move through step by step on the path to the autonomous pharmacy.
Fundamentally, the fully autonomous pharmacy is well within our reach. Much progress has been made towards this game-changing vision already with many pharmacies, hospitals and care homes adopting some level of automation as part of their medication dispensation practices.
Industry leaders must listen and respond to the consensus from pharmacists that there should be a move towards automation; it is clear that a fully autonomous pharmacy would reduce medication management errors and therefore increase patient and healthcare provider safety, as well as saving valuable time and money across the pharmacy sector. Omnicell’s response to the COVID-19 pandemic has further demonstrated this point because their technology has been vital in effectively supporting healthcare services with safe and efficient medication management during a period of unprecedented pressure and strain on the NHS.
The autonomous pharmacy means less time spent on administrative tasks and more time spent caring for patients face-to-face. With five clear components and a realisable framework already in use by some organisations, the autonomous pharmacy can and will happen on a wide scale in the UK. Thanks to this vision and the steps taken already to implement it, industry leaders are excited by and hopeful about the future of digital medication management.
Paul O’Hanlon, a pharmacist by profession, is now vice president of International Sales at Omnicell.
Founded in 1992, Omnicell is a leading provider of medication and supply management solutions to the global healthcare market. The company specialises in improving patient safety from hospital to home, and using better management of supplies and medications to improve standards of care by allowing clinicians to spend more times with their patients.
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