Who’s to blame for the lack of advancement in pharmacy automation and technology?

Without question there is a lack of advanced automation and technology in the acute care pharmacy setting. Spend some time in several acute care pharmacies if you don’t believe me. There’s clearly a need for it, but it’s just not being used.

I am a fan of automation and technology in any setting, but especially in the acute care pharmacy. I believe that the continued use, development and advancement of pharmacy technology should be a key component of any plan to change the current pharmacy practice model. Unfortunately, the situation is problematic because current pharmacy technology is either poorly designed for the needs of the pharmacy or the pharmacy in which it is used has a poorly designed workflow that doesn’t take advantage of it. Why is that? Who’s to blame; someone, anyone, no one? Valid questions.

I had an incredible opportunity this week to spend time with some people who research, design and implement pharmacy automation and technology. It’s eye-opening and refreshing to speak with people who are passionate about the same things as me. We all sat around a table in an informal, conversational manner and threw around a lot of ideas, talked philosophically about healthcare and gained insight into a great many things. The entire session was very productive and educational. But one of the most important messages I walked away with was the understanding that the designers of pharmacy automation and technology are not the limiting factor in the advancement of pharmacy practice; we are. Their ideas and thought processes are clearly ahead of the current thinking in healthcare, specifically pharmacy. I’m not exactly sure why pharmacy is slow to consider the future, and even slower to adopt new technologies, but here are some things I think might contribute to the problem:

• There is a clear lack of pharmacist involvement in the development of pharmacy automation and technology – Sure there are some pharmacists that dabble in software development, or play around with new technologies, but overall there appears to be little interest within the profession. I see this at meetings where informatics sessions have very few attendees, while the clinical sessions are bursting at the seams with pharmacists trying to get a peek at the latest information for disease state management, clinical application, etc. The most interesting thing about this scenario is that the information presented in the “clinical sessions” is rarely cutting edge. The information is valuable to many, but most, if not all of it can easily be found in the literature. Pharmacy automation and technology information, on the other hand, is often times much harder to come by. Take a look at the recent blog by Dennis Tribble. He touches on the software side of things only, but the idea is applicable across all pharmacy automation and technology.
• Healthcare administration fails to see the big picture – Hospital administration often fails to see the advantages of automation and technology implementation in the pharmacy. If you’ve ever worked in an acute care pharmacy you know exactly what I mean. It is a rare hospital indeed that can see the benefits of spending time, energy and money on improving pharmacy operations. How do you improve pharmacy operations? You streamline the distribution process, and one way to do that is through judicious use of automation and technology. What does improved pharmacy operations get you? Efficiency, which translates to more pharmacist time for clinical activities. What does increased pharmacist clinical activity get you? Fewer drug misadventures, better and safer patient care, and a significant cost savings to the healthcare system. Simple, logical, reasonable thought, but rare in the healthcare environment.
• There is a lack of innovators in the field – Let’s face it; if pharmacists were innovative we wouldn’t still be using the same practice model that we’ve had for over two decades. Even the recent PPMI Summit put on by ASHP offered relatively little innovative thinking. I haven’t had the opportunity to go through all the PPMI presentations, but what I’ve seen to date are simply iterations on the same old theme. We continue to speak in terms of “current” practice instead of talking about “future” practice. I think it’s time to pick a goal that seems crazy on the surface, and then start designing the methods and strategy to make it work. Somewhere along the way a vision of the future will emerge. Smartpumps, automated dispensing cabinets, carousel technology, automated packaging, robotics, etc are all valuable technologies used in pharmacy today. Yes, today. While we should continue to develop, standardize and streamline today’s technology, we must begin to investigate the future; period.
• There is a clear lack of pharmacy leadership from the top down – I don’t know how else to say this, but there are few leaders in the pharmacy world that have the foresight and testicular fortitude to do what needs to be done. One of the themes of the PPMI Summit was to “be bold”. To do that pharmacy leadership from the top of the corporate ladder to the front lines of pharmacy practice are going to have to make changes, lots of changes. We cannot be afraid to fall flat on our collective faces. The detriment to innovation and development is being in a comfort zone, and being afraid to do something that might not work. Failure is a tool, one that the profession of pharmacy has failed to utilize.
• Pharmacy refuses to be empowered – Vendors give us the ability to help ourselves, but we refuse to accept it. We refuse to utilize key features and concepts of the technology we have at our disposal and we refuse to take ownership of making sure the hardware and software we use is used to its fullest potential. Several times during the scrum described above someone asked me why I simply didn’t use a particular feature of a product to do something I was lamenting over. My typical response was that I wasn’t aware of the feature they were speaking about. That’s disappointing as I should be familiar with the product’s capabilities; my fault not theirs. The vendors create a product, provide the end users with training, produce training manuals and videos, have listservs for us to bounce ideas off other users and give us “help desks” that we can access for additional information when we get ourselves in trouble. What else can they do? They can’t force an end user to use the technology correctly or to its fullest potential. I’m guilty of putting blame on the vendors because it’s easier than working harder to get the most out of their systems. I think it’s time I changed my approach.

That’s it. We’re our own worst enemy. It’s time to point the finger at ourselves and critically evaluate our endgame. Let’s be honest with ourselves and work toward the answers, whatever they may be.

I’m looking forward to ASHP Midyear in December as it will give me the opportunity to visit with other pharmacists from across the country. I’m interested in finding out what the real opinion is about our future and where pharmacy automation and technology fits in that plan. I often gain more knowledge and information by spending time with these pharmacists than I do any other way. I’m excited about it and hope to see you there.