Pharmacy Automation Can Be a Means to Drug Safety


In the pharmacy, time is the ultimate value-add.

Part of the pharmacist’s oath is to “assure optimal outcomes for all patients.” With this, the first and foremost priority is patient safety and ensuring that patients get the right medication at the right time. Yet, each year in the United States alone, 7000 people die due to a medication error.1 Beyond the risk to patients, there is also significant cost associated with medication errors: According to the World Health Organization, the global cost of medication errors is estimated to be $42 billion annually, or almost 1% of total health expenditures.2

With burnout on the rise across the health care sector and the associated impact on clinician psychological and physical wellbeing, the potential for making mistakes is increasing.3 Further, although human error is not the only cause of medication errors, it can be assessed and addressed. This is where pharmacy automation technology can come into play. Through automation, medical technology companies are working with health care providers from hospitals to clinics to community pharmacies to find a safer way to dispense medications.4

While pharmacy automation isn’t a new concept, the field has truly evolved and rapidly grown within the last few decades. Today, pharmacy automation has advanced to tools such as high-speed automated robotic vial-filling and packaging technology, RFID-enabled will call storage and retrieval cabinets, and workflow software that allows for more visibility into dispensing activities and inventory. There is also technology available that utilizes advanced analytics to identify anomalous behavior, automate controlled substance reconciliation, and immediately flag discrepancies that may require investigation.

While pharmacy automation isn’t a new concept, the field has truly evolved and rapidly grown within the last few decades. Image Credit: © wladimir1804 -

While pharmacy automation isn’t a new concept, the field has truly evolved and rapidly grown within the last few decades. Image Credit: © wladimir1804 -

Automation can help pharmacists ensure the right medicine reaches the right patient. Additionally, pharmacy automation technology is available to support and empower pharmacists in a range of care settings, from retail chains and central fill operations to hospitals and other non-acute care settings (eg, long-term care, behavioral health, and hospice). By automating tasks like labeling and dispensing and by providing advanced analytics and security features, pharmacy automation technology has the power to give pharmacists time back in their days to practice at the top of their license.5 Further, by spending less of their workday on time-consuming manual tasks, pharmacists can more fully employ their clinical expertise.

Medication Errors in Filling and Dispensing

While the most common step of the medication management process for errors to occur is at the prescribing stage, another frequent point of human error is in dispensing.6 When you consider that research has shown that distractions are a major cause of errors in health care, it’s clear that the increased workloads facing pharmacists and the resulting burnout in the profession create heightened risk for errors.7

One potential solution is for pharmacies to hire more staff, but with ongoing labor challenges across the health care sector and pharmacies struggling to find applicants, it is often not feasible to increase the size of a team in response to growing scope of responsibilities. In these cases, many pharmacies are looking to technology to alleviate challenges associated with increased workload and burnout among pharmacists and pharmacy technicians.

A study on the impact of a robotic prescription-filling system on pharmacy staff activities and prescription-filling time showed that an automated vial filling system led to a statistically significant reduction in prescription filling time by 33 seconds per prescription.8 By automating time-consuming manual tasks like dispensing and vial-filling, pharmacists are empowered to shift their attention to patient-focused clinical care and expert consultation.4

Medication Errors as a Result of Non-Adherence

Medication errors do not stop once prescriptions are out of the hands of the health care professional. According to the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP), a medication error can result from health care professionals, patients, or consumers. Therefore, not taking medication as prescribed, better known as non-adherence, is also considered a medication error. This is a considerable issue in health care with an estimated 50% to 60% of patients not adhering to the correct dose of their prescribed medications.9 The implications of non-adherence are significant, leading to 125,000 preventable deaths annually and up to $289 billion in avoidable health care costs.10

When we discuss non-adherence, we generally look at it in 2 categories: intentional and unintentional.11 Examples of intentional non-adherence include a patient choosing not to take their prescribed medication due to cost or fear of adverse reactions. Examples of unintentional non-adherence can involve a patient forgetting to take their medication or struggling to maintain a complex medication regimen.

Pharmacy automation technology can help address non-adherence through automating the production of adherence packaging (eg, blister cards), which makes it easier for patients to understand and manage when and how to take their medications. Additionally, research has shown that adherence packaging can improve patient adherence outcomes.12,13

Dispensing and Data Privacy Considerations at Will Call

Patient health information data breaches can also be a dangerous and costly error for patients and pharmacies. According to the American Medical Association, penalties can range from $100 to $50,000 per violation. In my experience, one common place breaches can occur is at will call, when patients pick up their prescriptions. With a traditional will call set up of bins and bags, there is an inherent risk of a pharmacy staff inadvertently picking up the wrong bag and handing over sensitive health information to the wrong patient.

Automated will call cabinets were built with the intention of supporting pharmacists in ensuring the right medication goes to the right patient by using RFID technology to track medications and provide near real-time visibility as they move through the prescription filling process, automating storage, retrieval, and return to stock. Features like pick-to-light and sound technology support pharmacists in indicating exactly where to retrieve their correct prescription.

A Call to Action for Pharmacy Leaders

Across the health care sector, innovations in automation are helping clinicians manage their workload and provide the very best care to patients. Pharmacists are at the center of community-based health care, and we are passionate about empowering pharmacists to practice at the top of their licenses by spending less time on manual tasks and more time on providing hands-on care and counseling.

In the pharmacy, time is the ultimate value-add. Through automation, medication management can become safer, smarter, and simpler for pharmacists across all care settings, from a local community pharmacy to your bustling central fill operation.

About the Author

W. Perry Flowers, RPh, MS, is the vice president, Medical Affairs, Medication Management Solutions, Becton, Dickinson, and Company.


  1. Institute of Medicine Committee on Quality of Health Care in A. In: Kohn LT, Corrigan JM, Donaldson MS, eds. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press; 2000.
  2. WHO launches global effort to halve medication-related errors in 5 years. World Health Organization. Mar 29, 2017. Accessed December 12, 2023.
  3. Dee J, Dhuhaibawi N, Hayden JC. A systematic review and pooled prevalence of burnout in pharmacists. Int J Clin Pharm. 2022:1-10. doi:10.1007/s11096-022-01520-6
  4. Teagarden JR, Nagle B, Aubert RE, Wasdyke C, Courtney P, Epstein RS. Dispensing error rate in a highly automated mail-service pharmacy practice. Pharmacotherapy. 2005;25(11):1629-35. doi:10.1592/phco.2005.25.11.1629
  5. Angelo LB, Christensen DB, Ferreri SP. Impact of community pharmacy automation on workflow, workload, and patient interaction. J Am Pharm Assoc. 2005;45(2):138-44. doi:10.1331/1544345053623537
  6. Wilson DG, McArtney RG, Newcombe RG, et al. Medication errors in paediatric practice: insights from a continuous quality improvement approach. Eur J Pediatr. 1998;157(9):769-74. doi:10.1007/s004310050932.
  7. Westbrook JI, Woods A, Rob MI, Dunsmuir WTM, Day RO. Association of Interruptions With an Increased Risk and Severity of Medication Administration Errors. Archives of Internal Medicine. 2010;170(8):683-690. doi:10.1001/archinternmed.2010.65
  8. Lin AC, Huang YC, Punches G, Chen Y. Effect of a robotic prescription-filling system on pharmacy staff activities and prescription-filling time. Am J Health Syst Pharm. 2007;64(17):1832-9. doi:10.2146/ajhp060561.
  9. Lam WY, Fresco P. Medication Adherence Measures: An Overview. Biomed Res Int. 2015;2015:217047. doi:10.1155/2015/217047.
  10. Viswanathan M, Golin CE, Jones CD, et al. Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. Ann Intern Med. 2012;157(11):785-95. doi:10.7326/0003-4819-157-11-201212040-00538.
  11. Albrecht S. The Pharmacist’s Role in Medication Adherence. US Pharmacist. May 18, 2011. Accessed December 12, 2023.
  12. Schneider PJ, Murphy JE, Pedersen CA. Impact of medication packaging on adherence and treatment outcomes in older ambulatory patients. J Am Pharm Assoc. 2008;48(1):58-63. doi:10.1331/JAPhA.2008.07040
  13. Mahtani KR, Heneghan CJ, Glasziou PP, Perera R. Reminder packaging for improving adherence to self-administered long-term medications. Cochrane Database Syst Rev. 2011(9):Cd005025. doi:10.1002/14651858.CD005025.pub3
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