By Charles D. Shively, Ph.D., R.Ph., Chief Pharmacy Officer, RxStressRelief.com and PharmacyCE.com

Is today the day it all changes? No, not all. However, with government healthcare law changes, PBM regular adjustments, advancing MTM involvement, a longer list of immunizations, hospital pay for performance, pharmacist-required transition of care, and many other factors, it’s really about available time to perform necessary ALL pharmacy workflow functions.

Although manual counting will always be a part of our pharmacy environment, the real question is to what extent will counting by fives be reduced in the next five years. Some pharmacies with newer automated counting systems or automated dispensing systems have already reduced the number of manually counted prescriptions to 20% of their daily volume. Time savings? You bet. Stress relief? You bet.

One newer manual counting unit “picture counts” the dosage form shadow images and also ensures no miscounts. This unit also records the event photographically on its hard drive. This technology, supporting traditional manual dispensing, increases accuracy (tied to NDC, shape, and color) and speeds manual counting. Please recall, once again, with no quantity or drug misfills specific to each prescription.

The newer automated counting systems — different from “flow through” counters using weight or light sensing — overcome incorrect counts and reduce human involvement. Elimination of double counts is possible (as counts by these units are always accurate), while providing prescription queue information at the counting unit location.

Many of the newest pharmacy automated dispensing systems can complete up to seven of the 13 traditional prescription-filling steps (including drug selection, counting, filling, labeling, and vial capping) in less than one minute per prescription. Technology is in place that records the event photographically (dosage form medication is viewable in the vial after filling) and is available at final verification alongside the original prescription information. I value this feature to dissolve those “you didn’t count this right” comments. These newer machines don’t allow an incorrectly counted vial to be delivered.

The newest automated dispensing systems also allow nighttime filling without human oversight (through direct linkage to the IVR) and fill prescriptions as they are called in. Queue relief?

Truly surprising is that — depending upon the number of typical prescription pharmacy workflow steps a pharmacist wishes automation to perform and the number of elements in ROI where savings can occur — these “human robot resources” can be purchased and maintained at an equivalent human resource expense of $1 to $16 per hour of use. And it’s advisable that we pharmacists need to begin thinking of humanizing our automation — try giving them human names for a start. It goes a long way to creating acceptance.

In future columns, we will together evaluate some considerations that demonstrate how rapid ROI can occur for community pharmacies and hospital outpatient pharmacies considering automated systems.
And finally, as I like to say to my staff, “Thanks for coming in today.” CT