Automated medication management: an integrated vision for cutting errors

More streamlined medication workflows can improve patient safety and clinical staff efficiency, as well as reducing waste. Sebastien Villars, senior director of product management at Omnicell, anticipates the arrival of the autonomous pharmacy, enabled by robotics, integration and AI.

HITN: Tell us a little about current trends in terms of medication errors and their impact on hospital patient care?

Villars: We see that errors can typically happen at three levels: prescription (the wrong drug, based on patient history), dispensing (when the pill is moved to the patient) and administration (when the patient is given the pill). Medication workflows and processes are different in every country – but we know that two thirds of errors happen at administration level.

HITN: You’ve described a serious problem – so how can telehealth help to reduce this volume of errors?

Villars: I would say that connecting retail pharmacy and community health with the hospital in a digital way is clearly the approach required. It allows the consultant to see the full medication history of the patient.

A more advanced prescription system inside the hospital can connect with external services so the prescription can be double-checked. The clinician keeps control but a second reading by an AI algorithm can alert them to possible anomalies or conflicts with the medication.

Secured automated cabinets can dispense medication for a specific patient, so you extract from the cabinet only the medication that has been electronically prescribed and checked for that patient.

And then there is administration, where the solution checks it is the right medication for the right patient and that it is being given at the right time. If there is an issue, it will create an alert to warn nursing staff reversing the process to identify a resolution in real-time and avoiding potential error. This is the closed loop approach – managing the last metre of the process.

HITN: So we will probably see automation having an impact on more streamlined medication management, with robotics for example?

Villars: Certainly. These machines manage traceability: in the central pharmacy, big, workflow-dependent robots will extract from storage the right medication for the right wards or the right patient; on the wards, interoperable carts, shelves or cabinets will help the nurse to extract specific medication for a specific patient and then only the appropriate drawer will unlock. Inside the secure automated cabinet, you have a guiding light solution so you know exactly what you need to open in order to collect the prescription for the patient.

HITN: This will inevitably bring interoperability challenges. Is it just a matter of resolving them and the benefits of automation will flow?

Villars: I agree that interoperability is a challenge, but we really need to look at integration, at streamlining the work of our health professionals in hospitals instead of letting them jump from one application or system to another.

This is where AI can start coming into play. On medication workflows, you will probably have a few AI interplays around the prescription itself, but in administration there will be many interplays that perform administrative tasks on behalf of the nurse. If we want to have good-quality, trustable AI, we need to have good data in the pipeline – which is what interoperability enables. Improving interoperability will be beneficial for AI, helping the care-giver to focus on the patient rather than on administrative tasks.

HITN: It sounds as if this is where the vision of the autonomous pharmacy starts to become clearer?

Villars:Yes – I would say the vision is to decrease manual tasks as much as possible. By adopting a digital solution you can reduce waste, which is not only an economic benefit but also an environmental one too.

If you look at the Autonomous Pharmacy Framework, Level 5 is about zero waste. It’s more a north-star goal, but today you have enough good data to predict medication consumption based on time of year, population and age. Having the right inventory means zero waste. Finally, as we have seen during Covid-19, dynamic inventory management is a way to react quickly and predictively to fluctuating demand, increasing the resilience of hospital pharmacies.

Healthcare IT News spoke to Sebastien Villars, senior director of product management at Omnicell,​ as part of the ‘Summer Conversations’ series.

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